The impact of herbal treatments on cervicovaginal human papillomavirus infection: a systematic review and meta-analysis

Gençtürk, Nuran; Karaahmet, Aysu Yildiz; Cömert, Dilan

doi:10.1590/1806-9282.20240141

Acessibilidade / Reportar erro

Brasil

Revista da Associação Médica Brasileira

Español English

Brasil

Español English

sumário « anterior atual seguinte »

Sumário

Original Article • Rev. Assoc. Med. Bras. 70 (6) • 2024 • https://doi.org/10.1590/1806-9282.20240141 copy

The impact of herbal treatments on cervicovaginal human papillomavirus infection: a systematic review and meta-analysis

Authorship SCIMAGO INSTITUTIONS RANKINGS

SUMMARY

OBJECTIVE:

This systematic review and meta-analysis aimed to investigate the effects of herbal treatments on cervicovaginal human papillomavirus infection.

METHODS:

A comprehensive literature search was conducted in PubMed, Scopus, Science Direct, and the Cochrane Library until December 2023, following Cochrane guidelines. Data were analyzed using the Review Manager computer program (Version 5.4.1).

RESULTS:

Five randomized controlled trials involving a total sample size of 662 women were included in the study. The pooled odds ratio for individuals testing negative for human papillomavirus after herbal intervention among human papillomavirus-positive patients was 1.86 (95% confidence interval (CI) 0.64–5.43), according to the fixed-effects model. Three out of the five studies indicated a significant relationship. The relationship between positive human papillomavirus infection and herbal treatments, measured by the fixed-effects model, resulted in a pooled odds ratio of 0.41 (95%CI 0.17–1.01), reporting a significant association (p=0.05). Subgroup analysis revealed a significant reduction in the relationship between herbal treatment and atypical squamous cells of undetermined significance (OR 0.16, 95%CI 0.03–0.88, p=0.04) but no significant impact on the relationship between herbal treatment and low-grade squamous intraepithelial lesion (OR 0.33, 95%CI 0.01–8.77, p=0.51).

CONCLUSION:

The meta-analysis suggests that herbal treatments reduce human papillomavirus infections. While herbal treatments show a significant reduction in atypical squamous cells of undetermined significance, they do not significantly impact the regression of low-grade squamous intraepithelial lesions.

KEYWORDS:
HPV infection; Cervicovaginal lesions; Herbal; Treatment; Randomized controlled trial

References, country	Study design	Study period	Age	Sample size	Interventıon type	Intervention time and method	Control group	Outcomes
Aragona et al.¹1 Aragona C, Bezerra Espinola MS, Bilotta G, Porcaro G, Calcagno M. Evaluating the efficacy of Pervistop®, a new combination based on EGCG, folic acid, vitamin B12 and hyaluronic acid on patients with human papilloma virus (HPV) persistent infections and cervical lesions: a pilot study. J Clin Med. 2023;12(6):2171. https://doi.org/10.3390/jcm12062171 https://doi.org/10.3390/jcm12062171... , Italy	RCT	June 2022 to August 2022	Intervention: 37.35±2.60 Control: 37.65±2.48	Intervention: 20 Control: 20	Pervistop^® [200 mg epigallocatechin gallate (EGCG), 400 μg folic acid (FA), 1 mg vitamin B12, and 50 mg hyaluronic acid (HA)]	Time: 3 months Method: Oral Pervistop^® (200 mg epigallocatechin gallate) once daily	Control	HPV clearance: Intervention group: 17/20; Control group: 5/20 Cytological regression Intervention group: 3/20; Control group: 15/20
Nikakhtar et al.⁷7 Nikakhtar Z, Hasanzadeh M, Hamedi SS, Najafi MN, Tavassoli AP, Feyzabadi Z, et al. The efficacy of vaginal suppository based on myrtle in patients with cervicovaginal human papillomavirus infection: a randomized, double-blind, placebo trial. Phytother Res. 2018;32(10):2002-8. https://doi.org/10.1002/ptr.6131 https://doi.org/10.1002/ptr.6131... , Iran	RCT	November 2016 to December 2017	Intervention: 31.12±7.92 Placebo: 33.58±6.58	Intervention: 27 Placebo: 25	Myrtle	Time: 3 months Method: 20 vaginal suppositories for each month, 60 vaginal suppositories in total	Placebo	HPV clearance: Intervention group: 25/27; Placebo group: 17/25
Baleka Mutombo et al.⁶6 Baleka Mutombo A, Tozin R, Kanyiki H, Geertruyden JP, Jacquemyn Y. Impact of antiviral AV2 in the topical treatment of HPV-associated lesions of the cervix: results of a phase III randomized placebo-controlled trial. Contemp Clin Trials Commun. 2019;15:100377. https://doi.org/10.1016/j.conctc.2019.100377 https://doi.org/10.1016/j.conctc.2019.10... , Congo	RCT	July 2015 to July 2017	Intervention: 41.6±10.6 Placebo: 42.4±11.1	Intervention: 168 Placebo: 159	Antiviral AV2^®	Time: 6 months Method: spraying spray on cervix	Placebo	HPV clearance: Intervention group: 73/168; Placebo group: 61/159 Cytological regression Intervention group: 5/168; Placebo group: 13/159
Garcia et al.¹⁷17 Garcia FA, Cornelison T, Nuño T, Greenspan DL, Byron JW, Hsu CH, et al. Results of a phase II randomized, double-blind, placebo-controlled trial of Polyphenon E in women with persistent high-risk HPV infection and low-grade cervical intraepithelial neoplasia. Gynecol Oncol. 2014;132(2):377-82. https://doi.org/10.1016/j.ygyno.2013.12.034 https://doi.org/10.1016/j.ygyno.2013.12.... , United States of America	RCT	N/A	Intervention: 28.48±8.78 Placebo: 28.27±8.05	Intervention: 41 Placebo: 41	Polyphenon E	Time: 4 months Method: oral once daily, Polifenon E 800 mg	Placebo	HPV clearance: Intervention group: 10/41; Placebo group: 12/41
Basu et al.¹⁸18 Shanmugasundaram S, You J. Targeting persistent human papillomavirus infection. Viruses. 2017;9(8):229. https://doi.org/10.3390/v9080229 https://doi.org/10.3390/v9080229... , India	RCT	N/A	Intervention: 37.5 (35.8–39.2) Placebo: 38.3 (35.7–38.9)	Intervention: 79 Placebo: 82	Curcumin	Time: 4 months Method: Curcumin vaginal capsule (500 mg per application)	Placebo	HPV temizleme: Intervention group: 75/79; Placebo group: 81/82

Associação Médica Brasileira R. São Carlos do Pinhal, 324, 01333-903 São Paulo SP - Brazil, Tel: +55 11 3178-6800, Fax: +55 11 3178-6816 - São Paulo - SP - Brazil
E-mail: ramb@amb.org.br

Acompanhe os números deste periódico no seu leitor de RSS

[1] * Corresponding author: aysuyildiz@halic.edu.tr