Determinants of persistent and recurrent Chlamydia trachomatis infection in young women

Results of a multicenter cohort study

William L H Whittington, Charlotte Kent, Patricia Kissinger, M. Kim Oh, J. Fortenberry, Susan E. Hillis, Billy Litchfield, Gail A. Bolan, Michael E. St. Louis, Thomas A. Farley, H. Hunter Handsfield

Research output: Contribution to journalArticle

155 Citations (Scopus)

Abstract

Background: Sequelae of genital Chlamydia trachomatis infection in women are more strongly linked to repeat infections than to initial ones, and persistent or subsequent infections foster continued transmission. Objective: To identify factors associated with persistent and recurrent chlamydial infection in young women that might influence prevention strategies. Methods: Teenage and young adult women with uncomplicated C trachomatis infection attending reproductive health, sexually transmitted disease, and adolescent medicine clinics in five US cities were recruited to a cohort study. Persistent or recurrent chlamydial infection was detected by ligase chain reaction (LCR) testing of urine 1 month and 4 months after treatment. Results: Among 1,194 women treated for chlamydial infection, 792 (66.4%) returned for the first follow-up visit , 50 (6.3%) of whom had positive LCR results. At that visit, women who resumed sex since treatment were more likely to have chlamydial infection (relative risk [RR], 2.0;95% CI, 1.03-3.9), as were those who did not complete treatment (RR, 3.4; 95% CI, 1.6-7.3). Among women who tested negative for C trachomatis at the first follow-up visit, 36 (7.1%) of 505 had positive results by LCR at the second follow-up visit. Reinfection at this visit was not clearly associated with having a new sex partner or other sexual behavior risks; new infection was likely due to resumption of sex with untreated partners. Overall, 13.4% of women had persistent infection or became reinfected after a median of 4.3 months, a rate of 33 infections per 1,000 person months. Conclusions: Persistent or recurrent infection is very common in young women with chlamydial infection. Improved strategies are needed to assure treatment of women's male sex partners. Rescreening, or retesting of women for chlamydial infection a few months after treatment, also is recommended as a routine chlamydia prevention strategy.

Original languageEnglish
Pages (from-to)117-132
Number of pages16
JournalSexually Transmitted Diseases
Volume28
Issue number2
StatePublished - 2001

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Chlamydia Infections
Chlamydia trachomatis
Multicenter Studies
Cohort Studies
Infection
Ligase Chain Reaction
Adolescent Medicine
Therapeutics
Chlamydia
Reproductive Health
Sexually Transmitted Diseases
Sexual Behavior
Young Adult

ASJC Scopus subject areas

  • Dermatology
  • Public Health, Environmental and Occupational Health
  • Microbiology (medical)

Cite this

Whittington, W. L. H., Kent, C., Kissinger, P., Oh, M. K., Fortenberry, J., Hillis, S. E., ... Handsfield, H. H. (2001). Determinants of persistent and recurrent Chlamydia trachomatis infection in young women: Results of a multicenter cohort study. Sexually Transmitted Diseases, 28(2), 117-132.

Determinants of persistent and recurrent Chlamydia trachomatis infection in young women : Results of a multicenter cohort study. / Whittington, William L H; Kent, Charlotte; Kissinger, Patricia; Oh, M. Kim; Fortenberry, J.; Hillis, Susan E.; Litchfield, Billy; Bolan, Gail A.; St. Louis, Michael E.; Farley, Thomas A.; Handsfield, H. Hunter.

In: Sexually Transmitted Diseases, Vol. 28, No. 2, 2001, p. 117-132.

Research output: Contribution to journalArticle

Whittington, WLH, Kent, C, Kissinger, P, Oh, MK, Fortenberry, J, Hillis, SE, Litchfield, B, Bolan, GA, St. Louis, ME, Farley, TA & Handsfield, HH 2001, 'Determinants of persistent and recurrent Chlamydia trachomatis infection in young women: Results of a multicenter cohort study', Sexually Transmitted Diseases, vol. 28, no. 2, pp. 117-132.
Whittington, William L H ; Kent, Charlotte ; Kissinger, Patricia ; Oh, M. Kim ; Fortenberry, J. ; Hillis, Susan E. ; Litchfield, Billy ; Bolan, Gail A. ; St. Louis, Michael E. ; Farley, Thomas A. ; Handsfield, H. Hunter. / Determinants of persistent and recurrent Chlamydia trachomatis infection in young women : Results of a multicenter cohort study. In: Sexually Transmitted Diseases. 2001 ; Vol. 28, No. 2. pp. 117-132.
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abstract = "Background: Sequelae of genital Chlamydia trachomatis infection in women are more strongly linked to repeat infections than to initial ones, and persistent or subsequent infections foster continued transmission. Objective: To identify factors associated with persistent and recurrent chlamydial infection in young women that might influence prevention strategies. Methods: Teenage and young adult women with uncomplicated C trachomatis infection attending reproductive health, sexually transmitted disease, and adolescent medicine clinics in five US cities were recruited to a cohort study. Persistent or recurrent chlamydial infection was detected by ligase chain reaction (LCR) testing of urine 1 month and 4 months after treatment. Results: Among 1,194 women treated for chlamydial infection, 792 (66.4{\%}) returned for the first follow-up visit , 50 (6.3{\%}) of whom had positive LCR results. At that visit, women who resumed sex since treatment were more likely to have chlamydial infection (relative risk [RR], 2.0;95{\%} CI, 1.03-3.9), as were those who did not complete treatment (RR, 3.4; 95{\%} CI, 1.6-7.3). Among women who tested negative for C trachomatis at the first follow-up visit, 36 (7.1{\%}) of 505 had positive results by LCR at the second follow-up visit. Reinfection at this visit was not clearly associated with having a new sex partner or other sexual behavior risks; new infection was likely due to resumption of sex with untreated partners. Overall, 13.4{\%} of women had persistent infection or became reinfected after a median of 4.3 months, a rate of 33 infections per 1,000 person months. Conclusions: Persistent or recurrent infection is very common in young women with chlamydial infection. Improved strategies are needed to assure treatment of women's male sex partners. Rescreening, or retesting of women for chlamydial infection a few months after treatment, also is recommended as a routine chlamydia prevention strategy.",
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AU - Hillis, Susan E.

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