Whole‐Genome Characterization Reveals High Prevalence of Human Papillomavirus Type 18 Sublineage A1 With Novel Functional Polymorphisms Among Women in Northeastern Brazil

Few studies have characterized the complete genome of HPV18. Although incipient, its variant lineages and sublineages have been shown to have a set of polymorphisms associated with distinct risks for the development of high‐grade lesions and cervical cancer. Thus, this study aimed to characterize the complete genomic sequences of HPV18 from the state of Sergipe, Northeastern Brazil. Sequencing of 25 HPV18 genomes from women in Sergipe was performed using the Illumina platform. After bioinformatics analysis, genetic polymorphisms were characterized, and a phylogenetic analysis was performed. In total, approximately 45 unprecedented variable sites were identified, with 82.92% of the mutations being nonsynonymous and mapped to the functional domains of the viral proteins. In LCR, the identified mutations were associated with transcription factor binding sites, such as C/EBPα, YY1, and AP‐1. Phylogenetic analysis showed that all HPV18 isolates belonged to lineage A, sublineage A1. Clinically, 20.83% of patients had preinvasive lesions. These results show a relatively high incidence of HPV18 sublineage A1, presenting novel mutations in structural and functional domains of the proteins, which could potentially affect viral carcinogenesis. In this context, the importance of genomic surveillance of HPV18 variants worldwide is highlighted.