Human Papillomavirus Genotype Distribution and Co-Infection Patterns in Clinically Selected Iraqi Women: A Cross-Sectional Study

Background: Persistent infection with high-risk human papillomavirus (HPV) genotypes is the principal etiological factor in cervical carcinogenesis. However, HPV genotype distribution and co-infection patterns differ across populations and clinical settings. The present study aimed to characterize HPV genotypes and co-infection patterns among clinically selected Iraqi women with suspected HPV-associated disease. Methods: In this cross-sectional study, 100 clinically selected women attending clinics in Ramadi and Baghdad, Iraq (December 2025–July 2026), each contributed one specimen, collected by swab or superficial lesion scraping from a cervical, vulval, anal, or perianal site based on clinical assessment. HPV genotyping was performed by polymerase chain reaction followed by microarray hybridization, targeting 35 HPV genotypes. Results: HPV DNA was detected in 65 of 100 women (65.0%; 95% confidence interval, 55.3–73.6%). Of these, 48 had low-risk (LR)-only, 9 high-risk/potentially high-risk (HR/PHR)-only, and 8 mixed LR/HR/PHR infections. HPV-6 and HPV-11 were the most frequently detected genotypes (36 and 27 of 88 genotype detections, respectively), and multiple-genotype infections were identified in 20 women. Conclusions: HPV-6 and HPV-11 predominated in this clinically selected cohort, although HR/PHR and multiple-genotype infections were also identified. These preliminary, descriptive data highlight the need for larger, more representative studies of HPV genotype distribution in Iraq.