Score-matched analysis of human papillomavirus photodynamic therapy with Nocardia rubra and aminolevulinic powder

Effective clearance of high-risk human papillomavirus (HR-HPV) and disease remission are critical in managing cervical lesions. This study compared Nocardia rubra cell wall skeleton (Nr-CWS) versus 5-aminolevulinic acid photodynamic therapy for HR-HPV clearance and lesion regression. In this single-center retrospective cohort (June 2020-May 2023), 234 patients with HR-HPV infection were assessed. After 1:1 propensity matching, 144 patients remained (72 per group). Primary and secondary endpoints were HR-HPV clearance and disease remission rates, respectively. Baseline differences in thinprep cytologic test results persisted post-matching. Nr-CWS demonstrated superior HR-HPV clearance at 6 months (76.4% vs 48.6%; P < .001) and 1 year (87.5% vs 66.7%; P = .03). Disease remission rates showed no significant differences at 6 months (72.9% vs 85.5%; P = .10) or 1 year (78.0% vs 90.9%; P = .058). Nr-CWS significantly outperformed 5-aminolevulinic acid photodynamic therapy in achieving HR-HPV clearance, while both therapies showed comparable efficacy in disease remission.