Introduction: Background:
The threat of cervical carcinoma is still a major public health challenge in low- and middle-income countries, including India. In this context, disparate findings about HPV genotypes are reported from different regions of India. Interestingly, although HPV-16 and HPV-18 have demonstrated global supremacy as risk factors for cervical cancer, recent observations from India indicate a rising trend of high-risk non-18 genotypes.

Aim and objectives:
To assess the prevalence, distribution of genotypes, and molecular profile of the human papillomavirus in women presenting with suspected cervical pathology in the Agra region of North India. In addition, the cytology-VIA correlation and epidemiological risk factors in the region were assessed.

Material and Methods:
In this hospital-based cross-sectional study, the data were collected over a period of 18 months from April 2023 to January 2025. A total of 500 symptomatic women between the age group of 25 and 65 years were included from a tertiary care hospital in Agra. Cervical samples were obtained for the Pap smear, VIA, and HPV DNA. Genotyping for various types of HPV was done by real-time PCR for 28 types of HPV. Sociodemographic, reproductive, and behavioral factors of the subjects were taken into consideration.

Results:
The DNA of the human papillomavirus was detected in 13% of the 500 patients. There was no association between sociodemographic and behavioral factors. Abnormal cytology was found to be highly significantly associated with the presence of the human papillomavirus. Abnormal cytology was 74.7% associated with the presence of human papillomavirus ( p < 0.001). Pap smear was found to be 95.6% specific and 86.2% sensitive. VIA was found to be 100% sensitive but 62.8% specific. In the present study, the human papillomavirus type 16 was the most prevalent. In addition to human papillomavirus type 16, human papillomavirus type 39.

Conclusion:
This study underlines marked regional diversity in HPV genotypes at high risk other than HPV-16/18 and confirms a strong concordance between infection with high-risk human papillomavirus and cytological abnormalities. These findings raise the demand for genotype-informed surveillance of human papillomavirus infection, expanded vaccine coverage, and integrated screening to advance the effort at cervical cancer prevention in north India.