Chlamydia trachomatis Antibody Testing in Vaginal Mucosal Material versus Blood Samples of Women Attending a Fertility Clinic and an STI Clinic.
Background. Chlamydia infections often follow an asymptomatic course but may damage the reproductive tract. Chlamydia antibodies in serum are used as markers for past infections and can relate to tubal pathology and infertility. This "proof of principle" study aimed to assess whether Chlamydia antibodies are detectable in easier to obtain, noninvasive, vaginal mucosa samples and relate to current or past infection. Methods. We compared outcomes of Chlamydia IgG and IgA antibody tests in serum and vaginal mucosal swabs in (a) 77 women attending a fertility clinic, of whom 25 tested positive for serum-IgG and (b) 107 women visiting an STI centre, including 30 Chlamydia PCR-positive subjects. Results. In the STI clinic, active Chlamydia infections were linked to serum-IgG and serum-IgA (P < 0.001) and mucosa-IgA (P < 0.001), but not mucosa-IgG. In the fertility clinic, mucosa-IgG had stronger correlations with serum-IgG (P = 0.02) than mucosa-IgA (P = 0.06). Women with tubal pathology or Chlamydia history more commonly had serum-IgG and mucosa-IgA (both P < 0.001), whereas this link was weaker for mucosa-IgG (P = 0.03). Conclusion. Chlamydia IgG and IgA are detectable in vaginal mucosal material. Serum-IgG had stronger associations with current or past infections. Mucosa-IgA also showed associations with (past) infection and complications. IgA presence in vaginal mucosa warrants further epidemiological studies.
Epidemiology & Surveillance Unit, Centre for Infectious Disease Control, National Institute of Public Health and the Environment (RIVM), P.O. Box 1 (75), 3720 BA Bilthoven, The Netherlands.
Ingrid V F
IV
van den Broek
Department of Obstetrics and Gynaecology, University Medical Center Groningen, University of Groningen, P.O. Box 30.001, 9700 RB Groningen, The Netherlands.
Jolande A
JA
Land
Epidemiology & Surveillance Unit, Centre for Infectious Disease Control, National Institute of Public Health and the Environment (RIVM), P.O. Box 1 (75), 3720 BA Bilthoven, The Netherlands ; STI AIDS Netherlands (SOA AIDS Nederland), P.O. Box 10845, 1001 EV Amsterdam, The Netherlands ; Department of General Practice, AMC-UVA, P.O. Box 22660, 1100 DD Amsterdam, The Netherlands.
Jan E A M
JE
van Bergen
Laboratory of Immunogenetics, Department of Medical Microbiology and Infection Control, VU University Medical Centre, De Boelelaan 1105, 1081 HV Amsterdam, The Netherlands ; Institute of Public Health Genomics, Department of Genetics and Cell Biology, Research Institutes CAPHRI and GROW, Faculty of Health, Medicine & Life Sciences, University of Maastricht, P.O. Box 616, 6200 MD Maastricht, The Netherlands.
Servaas A
SA
Morré
Epidemiology & Surveillance Unit, Centre for Infectious Disease Control, National Institute of Public Health and the Environment (RIVM), P.O. Box 1 (75), 3720 BA Bilthoven, The Netherlands ; Julius Centre UMCU, P.O. Box 85500, 3508 GA Utrecht, The Netherlands.
Marianne A B
MA
van der Sande