Anti-HPV gel versus interferon α-2b gel as adjuvant therapy after LEEP for HSIL with HR-HPV infection on clinical outcomes, vaginal microecology, and biomarkers of proliferation and immunity

Objective To evaluate and compare the efficacy, impact on vaginal microbiota, changes in inflammatory/immune/proliferation biomarkers, and safety profile of Anti-HPV gel versus Interferon α-2b gel as adjuvant therapies after LEEP in patients with HSIL and HR-HPV infection. Methods This retrospective cohort study included 207 eligible patients diagnosed with HSIL and HR-HPV infection who underwent initial LEEP between January 2023 and January 2025. Patients were divided into a control group (n=102, Interferon α-2b gel) and an observation group (n=105, Anti-HPV gel), both receiving two standardized treatment courses post-operatively. Outcome measures included total clinical effective rate, vaginal microecological recovery (pH, Nugent score), serum inflammatory cytokines (IL-17, TNF-α, IFN-γ, TGF-β), immunoglobulins (IgA, IgG, IgM), cell proliferation markers (serum Survivin, cervical tissue Ki-67), adverse events, and 6-month HR-HPV recurrence rate. An exploratory model was constructed using post-treatment indicators to predict recurrence. Results Compared with the control group, the observation group showed superior outcomes across multiple domains: a higher total clinical effective rate (87.62% vs. 75.49%, P = 0.024); better restoration of vaginal microecology with lower post-treatment pH (4.29 ± 0.37 vs. 4.78 ± 0.42, P<0.001) and Nugent score (2.96 ± 1.15 vs. 4.52 ± 1.37, P<0.001); greater reductions in serum inflammatory markers (IL-17, TNF-α, IFN-γ, TGF-β, all P<0.001); greater increases in immunoglobulins (IgA, IgG, IgM, all P<0.001); more pronounced decreases in cell proliferation markers (serum Survivin and tissue Ki-67, both P<0.001); a lower 6-month HR-HPV recurrence rate (6.67% vs. 16.67%, P = 0.024) with comparable overall adverse event incidence (10.48% vs. 13.73%, P = 0.473). The exploratory predictive model based on post-treatment indicators demonstrated good discrimination for recurrence (AUC = 0.812, 95% CI: 0.747–0.878). Conclusion In conclusion, as a postoperative adjuvant, Anti-HPV gel demonstrated superior clinical and biomarker outcomes compared to Interferon α-2b gel, with a favorable safety profile and lower short-term recurrence risk, suggesting its promising clinical value pending prospective confirmation.