{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,27]],"date-time":"2026-08-27T11:23:34Z","timestamp":1787829814288,"version":"build-2784847793"},"reference-count":45,"publisher":"MDPI AG","issue":"9","license":[{"start":{"date-parts":[[2026,8,27]],"date-time":"2026-08-27T00:00:00Z","timestamp":1787788800000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Vaccines"],"abstract":"<jats:p>Background\/Objectives: Regional HPV genotype data for the Yangtze River Delta remain scarce, limiting evidence-based vaccine and screening policies. This study characterised the HPV genotype distribution, the vaccine protection gaps, and the co-infection network structure among clinical women in Wuxi, a prefecture-level city in the Yangtze River Delta region of Jiangsu Province, China. Methods: We retrospectively analysed all 8515 cervical HPV genotyping records from Xishan People\u2019s Hospital of Wuxi City (January 2024\u2013June 2025) using a 23-type fluorescent PCR panel classified by the International Agency for Research on Cancer (IARC) criteria. Results: The overall HPV prevalence was 22.83% (1944\/8515; 95% CI 21.9\u201323.8%). The five leading types were HPV52 (4.82%), HPV58 (3.14%), HPV16 (2.96%), HPV53 (2.50%), and HPV42 (2.08%); HPV18 (0.74%) ranked below two unvaccinated carcinogens, HPV51 (1.76%, IARC Group 1) and HPV68 (1.68%, Group 2A). The age-stratified prevalence was U-shaped (\u03c72 = 123.27, p &lt; 0.001), peaking at \u226420 years (52.94%; exploratory, n = 51) and \u226561 years (34.66%). Among the 1944 women with positive results, 43.0% were completely unprotected by the nonavalent vaccine, and 60.4% harboured at least one non-9vHPV type; HPV51 and HPV68 together accounted for 15.08% of the positive cases. In the co-infection network (n = 585 multiple-type infections), HPV52 achieved the highest degree centrality (281 co-infection events; normalised degree = 0.0218) and appeared in 8 of the 15 most frequent dual-type pairs, with observed\/expected ratios of 6.5\u201314.8-fold. Conclusions: These findings reveal a clinically substantial vaccine protection gap and support the prioritisation of HPV51 and HPV68 in next-generation vaccine design.<\/jats:p>","DOI":"10.3390\/vaccines14090741","type":"journal-article","created":{"date-parts":[[2026,8,27]],"date-time":"2026-08-27T10:58:21Z","timestamp":1787828301000},"page":"741","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["HPV Genotype Distribution, Vaccine Protection Gaps, and Co-Infection Network Centrality Among 8515 Clinical Women in Wuxi, China: A Retrospective Cross-Sectional Study"],"prefix":"10.3390","volume":"14","author":[{"ORCID":"https:\/\/orcid.org\/0009-0001-9543-5319","authenticated-orcid":false,"given":"Baocai","family":"Ran","sequence":"first","affiliation":[{"name":"Department of Clinical Laboratory, Xishan People\u2019s Hospital of Wuxi City, No. 1128 Dacheng Road, Xishan District, Wuxi 214105, China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Han","family":"Wu","sequence":"additional","affiliation":[{"name":"Department of Social Medicine, Graduate School of Medicine, Hirosaki University, 5 Zaifu-cho, Hirosaki 036-8562, Aomori, Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Fengjuan","family":"Zhang","sequence":"additional","affiliation":[{"name":"Information Big Data Center, Affiliated Hospital of Jiangnan University, No. 200 Huihe Road, Binhu District, Wuxi 214122, China"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1968","published-online":{"date-parts":[[2026,8,27]]},"reference":[{"key":"ref_1","first-page":"229","article-title":"Global cancer statistics 2022: GLOBOCAN estimates of incidence and mortality worldwide for 36 cancers in 185 countries","volume":"74","author":"Bray","year":"2024","journal-title":"CA Cancer J. 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