Ali N Russell1, Xiaojing Zheng1, Catherine M O'Connell1, Brandie D Taylor2, Harold C Wiesenfeld3, Sharon L Hillier3, Wujuan Zhong4, Toni Darville1. 1. Department of Pediatrics, University of North Carolina-Chapel Hill. 2. Department of Epidemiology and Biostatistics, Texas A&M Health Science Center, College Station. 3. Department of Obstetrics, Gynecology, and Reproductive Sciences, University of Pittsburgh and Magee Womens Research Institute, Pennsylvania. 4. Department of Biostatistics, University of North Carolina-Chapel Hill.
Abstract
BACKGROUND: Chlamydia trachomatis genital tract infection is a major cause of female reproductive morbidity. Risk factors for ascending infection are unknown, and the role for antibody in protection is not well established. METHODS: We recruited 225 women from urban outpatient clinics and followed them for a median of 12 months. We performed a cross-sectional analysis of serum anti-chlamydial immunoglobulin G (IgG), behavioral factors, and microbiological factors associated with endometrial infection at enrollment, and a longitudinal analysis of factors associated with incident infection. RESULTS: Oral contraceptives (adjusted relative risk [RR], 2.02 [95% confidence interval {CI}, 1.38-2.97]) and gonorrhea (adjusted RR, 1.66 [95% CI, 1.07-2.60]) were associated with endometrial infection. Gonorrhea (adjusted hazard ratio [HR], 3.09 [95% CI, 1.41-6.78]), cervical infection at enrollment (adjusted HR, 2.33 [95% CI, 1.07-5.11]), and exposure to uncircumcised partners (adjusted HR, 2.65 [95% CI, 1.21-5.82]) or infected partners (adjusted HR, 4.99 [95% CI, 2.66-9.39]) significantly increased the risk of incident infection. Seropositivity was associated with a reduced cervical burden (P < .05) but no differences in rates of ascending infection (adjusted RR, 1.24 [95% CI, .71-2.19]) or incident infection (adjusted HR, 0.94 [95% CI, .52-1.69]). CONCLUSIONS: Serum anti-chlamydial IgG is not associated with a lowered rate of ascending or repeat infection. Identification of factors associated with ascending infection and increased risk of incident infection provide guidance for targeted screening of women at increased risk for sequelae.
BACKGROUND:Chlamydia trachomatis genital tract infection is a major cause of female reproductive morbidity. Risk factors for ascending infection are unknown, and the role for antibody in protection is not well established. METHODS: We recruited 225 women from urban outpatient clinics and followed them for a median of 12 months. We performed a cross-sectional analysis of serum anti-chlamydial immunoglobulin G (IgG), behavioral factors, and microbiological factors associated with endometrial infection at enrollment, and a longitudinal analysis of factors associated with incident infection. RESULTS: Oral contraceptives (adjusted relative risk [RR], 2.02 [95% confidence interval {CI}, 1.38-2.97]) and gonorrhea (adjusted RR, 1.66 [95% CI, 1.07-2.60]) were associated with endometrial infection. Gonorrhea (adjusted hazard ratio [HR], 3.09 [95% CI, 1.41-6.78]), cervical infection at enrollment (adjusted HR, 2.33 [95% CI, 1.07-5.11]), and exposure to uncircumcised partners (adjusted HR, 2.65 [95% CI, 1.21-5.82]) or infected partners (adjusted HR, 4.99 [95% CI, 2.66-9.39]) significantly increased the risk of incident infection. Seropositivity was associated with a reduced cervical burden (P < .05) but no differences in rates of ascending infection (adjusted RR, 1.24 [95% CI, .71-2.19]) or incident infection (adjusted HR, 0.94 [95% CI, .52-1.69]). CONCLUSIONS: Serum anti-chlamydial IgG is not associated with a lowered rate of ascending or repeat infection. Identification of factors associated with ascending infection and increased risk of incident infection provide guidance for targeted screening of women at increased risk for sequelae.
Authors: J M Baeten; P M Nyange; B A Richardson; L Lavreys; B Chohan; H L Martin; K Mandaliya; J O Ndinya-Achola; J J Bwayo; J K Kreiss Journal: Am J Obstet Gynecol Date: 2001-08 Impact factor: 8.661
Authors: Ali N Russell; Xiaojing Zheng; Catherine M O'Connell; Harold C Wiesenfeld; Sharon L Hillier; Brandie D Taylor; Michelle D Picard; Jessica B Flechtner; Wujuan Zhong; Lauren C Frazer; Toni Darville Journal: J Infect Dis Date: 2016-10-12 Impact factor: 5.226
Authors: Brandie D Taylor; Xiaojing Zheng; Toni Darville; Wujuan Zhong; Kranti Konganti; Olayinka Abiodun-Ojo; Roberta B Ness; Catherine M O'Connell; Catherine L Haggerty Journal: Sex Transm Dis Date: 2017-01 Impact factor: 2.830
Authors: Xiaojing Zheng; Catherine M O'Connell; Wujuan Zhong; Uma M Nagarajan; Manoj Tripathy; De'Ashia Lee; Ali N Russell; Harold Wiesenfeld; Sharon Hillier; Toni Darville Journal: J Immunol Date: 2018-03-12 Impact factor: 5.422
Authors: Melinda A B Petrina; Lisa A Cosentino; Harold C Wiesenfeld; Toni Darville; Sharon L Hillier Journal: Anaerobe Date: 2019-02-10 Impact factor: 3.331
Authors: Taylor B Poston; De'Ashia E Lee; Toni Darville; Wujuan Zhong; Li Dong; Catherine M O'Connell; Harold C Wiesenfeld; Sharon L Hillier; Gregory D Sempowski; Xiaojing Zheng Journal: J Infect Dis Date: 2019-06-19 Impact factor: 5.226
Authors: Brandie D Taylor; Xiaojing Zheng; Catherine M O'Connell; Harold C Wiesenfeld; Sharon L Hillier; Toni Darville Journal: Sex Transm Infect Date: 2018-03-21 Impact factor: 3.519
Authors: Toni Darville; Hannah L Albritton; Wujuan Zhong; Li Dong; Catherine M O'Connell; Taylor B Poston; Alison J Quayle; Nilu Goonetilleke; Harold C Wiesenfeld; Sharon L Hillier; Xiaojing Zheng Journal: Am J Reprod Immunol Date: 2019-03-18 Impact factor: 3.886