Topical photodynamic therapy with 5-aminolevulinic acid for cervical high-risk HPV infection

• In this prospective case-control study, topical 5-aminolevulinic acid photodynamic therapy was investigated to be an effective, safe and well tolerated treatment for persistent cervical HR-HPV infection and CIN I.

ObjectiveTo investigate the clinical efficacy of 5-aminolevulinic acid photodynamic therapy (ALA–PDT) for cervical high-risk HPV (HR-HPV) infection.MethodsIn this prospective study, a total of 76 patients with persistent cervical HR-HPV infection were randomly divided into two groups. The treatment group (39 patients) received three treatments of ALA–PDT at two-week intervals. The control group (37 patients) received no treatment. All patients were followed up for 9 months. Hybrid Capture HPV DNA Assay and ThinPrep cytology test (TCT) were performed for both groups. Patients with abnormal TCT results received colposcopic biopsy before treatment and during follow-ups.ResultsHR-HPV remission rates were 64.10% (25/39) in the treatment group and 24.32% (9/37) in the control group at 3 month follow-up. Complete remission rates were 76.92% (30/39) and 32.40% (12/37), respectively, in the two groups at 9 month follow-up. There was a statistically significant difference between the two groups (P < 0.01). Conversion rates of abnormal TCT results were 81.81% (9/11) in the treatment group and 12.50% (1/8) in the control group at 3 months, and 90.90% (10/11) and 25.00% (2/8), respectively, at 9 months. Five of six patients with CIN I in the treatment group and no patients in the control group achieved complete response at 9 months. There was a statistically significant difference between the two groups (P < 0.01).ConclusionTopical ALA–PDT is an effective, safe and well tolerated treatment for cervical HR-HPV infection.