Minimal dataset.

Zinc plays a crucial role in maintaining immune balance in the human body. Zinc is believed to substantially affect cytokine synthesis and signaling; thus potentially combating viral infections, including Human Papillomavirus infection, through various mechanisms. Several randomized controlled trials (RCTs) have investigated whether oral zinc sulphate can improve viral warts; however, no comprehensive data is currently available. Therefore, we conducted a meta-analysis to evaluate the effectiveness of oral zinc sulphate for the treatment of viral warts. On July 1, 2024, we performed an extensive database search on PubMed, Embase, Web of Science, Cochrane CENTRAL, and ClinicalTrials.gov. Initially, 952 studies were identified, and after screening, 7 studies were included in the final analysis. Our findings showed that the total clearance rate of warts was significantly higher in the oral zinc sulphate group than in the control group (risk difference = 0.288; 95% CI = 0.087–0.489; p = 0.005). Subgroup analysis revealed that this therapeutic effect was more pronounced in individuals with low initial plasma zinc levels (risk difference = 0.767; 95% CI = 0.649–0.885; p < 0.001). Additionally, meta-regression showed that rise in zinc ion levels post-treatment were correlated with better treatment outcomes (coefficient = 0.0068; p < 0.001). Furthermore, for patients receiving traditional warts treatment, combining oral zinc sulphate significantly reduced the 6-month recurrence rate (log risk ratio = −1.043; 95% CI = −1.666 – −0.420; p = 0.001). The most common treatment-related side effects were nausea (risk difference = 0.562; 95% CI = 0.088–1.036; p = 0.020) and vomiting (risk difference = 0.205; 95% CI = 0.092–0.317; p < 0.001). Based on this evidence, oral zinc sulphate monotherapy offers notable benefits to those avoiding conventional treatments, and when combined with traditional therapies for viral warts, it can notably reduce recurrence rates over six months.

锌在维持人体免疫平衡中发挥关键作用。现有研究表明，锌可显著影响细胞因子的合成与信号传导，从而通过多种潜在机制对抗包括人乳头瘤病毒（Human Papillomavirus）感染在内的病毒感染。此前已有多项随机对照试验（randomized controlled trials, RCTs）探讨口服硫酸锌对病毒性疣的改善效果，但目前尚无综合可用的研究数据。因此，本研究开展了一项荟萃分析，以评估口服硫酸锌治疗病毒性疣的有效性。
2024年7月1日，我们对PubMed、Embase、Web of Science、Cochrane CENTRAL及ClinicalTrials.gov进行了全面的数据库检索。初始共检索到952项研究，经筛选后最终纳入7项研究进行最终分析。
研究结果显示，口服硫酸锌组的疣体完全清除率显著高于对照组（风险差=0.288；95%置信区间[CI]=0.087–0.489；p=0.005）。亚组分析表明，该治疗效果在初始血浆锌水平较低的人群中更为显著（风险差=0.767；95%CI=0.649–0.885；p<0.001）。此外，荟萃回归分析显示，治疗后锌离子水平的升高与更佳的治疗结局呈正相关（回归系数=0.0068；p<0.001）。进一步分析发现，对于接受传统疣治疗的患者，联合口服硫酸锌可显著降低6个月复发率（对数风险比=−1.043；95%CI=−1.666 – −0.420；p=0.001）。最常见的治疗相关不良反应为恶心（风险差=0.562；95%CI=0.088–1.036；p=0.020）与呕吐（风险差=0.205；95%CI=0.092–0.317；p<0.001）。
基于上述证据，口服硫酸锌单药治疗可为规避传统治疗的患者带来显著获益；而当与病毒性疣的传统治疗方案联用时，可显著降低6个月随访期内的复发率。