Risk of sequelae after Chlamydia trachomatis genital infection in women

Haggerty, Catherine L; Gottlieb, Sami L; Taylor, Brandie D; Low, Nicola; Xu, Fujie; Ness, Roberta B (2010). Risk of sequelae after Chlamydia trachomatis genital infection in women. Journal of infectious diseases, 201 Suppl 2, S134-S155. Cary, N.C.: The University of Chicago Press 10.1086/652395

	Text Haggerty JInfectDis 2010.pdf - Published Version Restricted to registered users only Available under License Publisher holds Copyright. Download (360kB)
Preview	Text 201-Supplement_2-S134.pdf - Other Available under License Publisher holds Copyright. Download (590kB) | Preview

Chlamydia trachomatis infection, the most common reportable disease in the United States, can lead to pelvic inflammatory disease (PID), infertility, ectopic pregnancy, and chronic pelvic pain. Although C. trachomatis is identified among many women who receive a diagnosis of PID, the incidence and timing of PID and long-term sequelae from an untreated chlamydial infection have not been fully determined. This article examines evidence reviewed as part of the Centers for Disease Control and Prevention Chlamydia Immunology and Control Expert Advisory Meeting; 24 reports were included. We found no prospective studies directly assessing risk of long-term reproductive sequelae, such as infertility, after untreated C. trachomatis infection. Several studies assessed PID diagnosis after untreated chlamydial infection, but rates varied widely, making it difficult to determine an overall estimate. In high-risk settings, 2%-5% of untreated women developed PID within the approximately 2-week period between testing positive for C. trachomatis and returning for treatment. However, the rate of PID progression in the general, asymptomatic population followed up for longer periods appeared to be low. According to the largest studies, after symptomatic PID of any cause has occurred, up to 18% of women may develop infertility. In several studies, repeated chlamydial infection was associated with PID and other reproductive sequelae, although it was difficult to determine whether the risk per infection increased with each recurrent episode. The present review critically evaluates this body of literature and suggests future research directions. Specifically, prospective studies assessing rates of symptomatic PID, subclinical tubal damage, and long-term reproductive sequelae after C. trachomatis infection; better tools to measure PID and tubal damage; and studies on the natural history of repeated chlamydial infections are needed.

Interest & Impact

Downloads

169 since deposited on 04 Oct 2013
13 in the past 12 months

Citations

5 Citations in Web of Science ®
6 Citations in Scopus

Search

in Google Scholar™

Services

Actions (login required)

Edit item

Actions (login required)

Edit item