Effectiveness of Lactobacillus therapy in women with cervical human papillomavirus infection: A systematic review and meta-analysis

Objective: This study evaluated the therapeutic efficacy of Lactobacillus in women with cervical human papillomavirus infection. Specifically, it aimed to assess the impact of Lactobacillus therapy on human papillomavirus clearance and cervical lesion resolution in clinical settings. Methods: A literature search was conducted in October 2024 using PubMed, EBSCO, Google Scholar, and ScienceDirect. Eligible studies included randomized controlled trials and quasi-randomized controlled trials investigating Lactobacillus therapy for human papillomavirus infection. This review followed the Preferred Reporting Items for Systematic Review and Meta-Analysis guidelines. Risk of bias was assessed using the risk of bias 2.0 and ROBINS-I (Risk Of Bias In Non-randomized Studies â�� of Interventions) tools. Data were analyzed using a random-effects model with 95 confidence intervals, and heterogeneity was evaluated using the I²statistic. A subgroup analysis was performed based on the method of administration (oral vs. vaginal). Results: Five studies were included in the meta-analysis. Among 326 participants assessed for lesion resolution, Lactobacillus therapy showed a statistically significant improvement (relative risk = 1.93, 95 confidence interval: 1.47â��2.53, p < 0.00001; I² = 0). Similarly, among the 262 participants assessed for viral clearance, the treatment showed a statistically significant effect (relative risk = 1.39, 95 confidence interval: 1.00â��1.94, p = 0.05; I² = 33). Conclusion: In patients with low-grade squamous intraepithelial lesions/atypical squamous cells of undetermined significance cervical lesions, Lactobacillus therapy administered over a minimum duration of 6 months may serve as an adjuvant treatment for human papillomavirus infection. © The Author(s) 2025. Creative Commons Non Commercial CC BY-NC: This article is distributed under the terms of the Creative Commons Attribution-NonCommercial 4.0 License (https://creativecommons.org/licenses/by-nc/4.0/) which permits non-commercial use, reproduction and distribution of the work without further permission provided the original work is attributed as specified on the SAGE and Open Access pages (https://us.sagepub.com/en-us/nam/open-access-at-sage).