HPV negative conversion following Hiporfin PDT for HPV associated HSIL in the female lower reproductive tract

Currently, there is no relevant literature specifically discussing the human papillomavirus (HPV) negative conversion rate following Hiporfin photodynamic therapy (PDT) in HPV-associated high-grade squamous intraepithelial lesion (HSIL) of the female lower reproductive tract. Our study aims to fill this gap. Prospective study of 91 patients aged 37.4 ± 13.2 years old with HSIL in the female lower reproductive tract (cervical HSIL: 55, vaginal HSIL: 25, cervical HSIL combined with vaginal HSIL: 8, cervical HSIL combined with vulvar HSIL: 1, vaginal HSIL combined with vulvar HSIL: 2). Hiporfin^® (2 mg/kg) was administered intravenously, and 48-72 h later, 630-nm laser irradiation was applied to the lesions. The median follow-up period was 36 months. Before treatment, all patients (91/91, 100%) tested positive for HPV, and only 6 patients (6/91, 6.6%) had been previously vaccinated against HPV. The HPV negative conversion rates were 74.5% (41/55), 89.1% (49/55), 89.8% (44/49) and 95.8% (23/24) at 3-6 months, 12 months, 24 months and 36 months respectively after PDT in treating cervical HSIL. For vaginal HSIL, the negative conversion rates were 28.0% (7/25) at 3-6 months, 52.0% (13/25) at 12 months, 60.9% (14/23) at 24 months, and 64.7% (11/17) at 36 months. In cases of multiple sites of female lower genital tract HSIL, the negative conversion rates were 18.2% (2/11), 45.5% (5/11), 60.0% (6/10), and 62.5% (5/8) at 3-6, 12, 24, and 36 months, respectively. Hiporfin-PDT was most effective in achieving HPV negative conversion for treating cervical HSIL, followed by vaginal HSIL, and finally for multisite female lower genital tract HSIL.