Wastewater-Based Epidemiology for Analysis of Human Papillomavirus Infections in a Uruguayan Urban Area

Human papillomavirus (HPV) is primarily transmitted through sexual contact and is classified into high- and low-risk genotypes based on their association with cancer development. High-risk (HR) genotypes, such as 16 and 18, among others, have been identified as responsible for the development of cervical cancer while low-risk (LR) genotypes, such as 6 and 11, among others, cause anogenital warts. The aim of this study was to determine the presence of HPV genotypes in wastewater from the wastewater treatment plant of the city of Salto, Uruguay in order to analyze the circulating HPV strains in their population. These samples were subjected to qualitative PCR analysis, and genotypes were identified through sequencing of the DNA products. HPV 6, 16, 31, 66, 81, 84, and 145 were frequently detected in wastewater and HPV 6 and 16 were the prevalent in cytological samples. A great diversity of genotypes was evident in the wastewater of the city. The approach of wastewater-based epidemiology as a representation of the circulating HPV genotypes in the population is adequate and an important tool for molecular epidemiologic studies mainly in developing countries such as Uruguay where information concerning genotypes circulation is scarce.