title: Persistence of Chlamydia trachomatis infection detected by polymerase chain reaction in untreated patients.
abstract: BACKGROUND
  Prior studies have used Chlamydia trachomatis culture methods to demonstrate both persistence and spontaneous clearance of genital C trachomatis infection.
  
  
  OBJECTIVE
  To further assess the issue of persistence and spontaneous clearance of C trachomatis infection, untreated men and women were evaluated with repeated polymerase chain reaction (PCR) testing.
  
  
  METHODS
  Ninety four untreated patients with a prior positive C trachomatis PCR test returning to the Denver Metro Sexually Transmitted Disease Clinic were retested by PCR.
  
  
  RESULTS
  The median and range intervals from initial to follow-up testing were 9.0 (2-112) days for men and 10.0 (2-231) days for women. Repeated PCR tests were positive for 29 of 36 men (80.6%) and 45 of 58 women (77.6%). Persistent PCR positivity did not decrease with a longer testing interval. By multivariate analysis, independent predictors of a persistently positive PCR test included nonwhite ethnicity, an interval of more than 3 days since last sexual encounter before the initial test, and an initial PCR optical density value of greater than or equal to 3.0.
  
  
  CONCLUSIONS
  In the absence of treatment, a large majority of patients testing positive for C trachomatis by PCR are likely to remain positive for variable periods of time, increasing the risk of transmission and immune-mediated damage. A low initial optical density value and recent sexual contact may be markers for exposure that does not establish infection.
authors.affiliation: Denver Department of Public Health, 605 Bannock Street, Denver, Colorado 80204, USA.
authors.forename: James L
authors.initials: JL
authors.lastname: Joyner
authors.forename: John M
authors.initials: JM
authors.lastname: Douglas
authors.forename: Mark
authors.initials: M
authors.lastname: Foster
authors.forename: Franklyn N
authors.initials: FN
authors.lastname: Judson
mesh_terms: D000328:Adult; D002584:Cervix Uteri / Q000382:microbiology; D002690:Chlamydia Infections / Q000175:diagnosis* / Q000453:epidemiology* / Q000382:microbiology / Q000652:urine; D002692:Chlamydia trachomatis / Q000235:genetics / Q000302:isolation & purification; D003120:Colorado / Q000453:epidemiology; D003151:Community Health Centers; D004269:DNA, Bacterial / Q000235:genetics; D005188:False Negative Reactions; D005260:Female; D052776:Female Urogenital Diseases / Q000175:diagnosis* / Q000453:epidemiology* / Q000382:microbiology / Q000652:urine; D006801:Humans; D008297:Male; D052801:Male Urogenital Diseases; D016133:Polymerase Chain Reaction / Q000592:standards
chemical_list: D004269:DNA, Bacterial