Advancing the public health applications of Chlamydia trachomatis serology

Abstract

Genital Chlamydia trachomatis infection is the most commonly diagnosed sexually transmitted infection. Trachoma is caused by ocular infection with C trachomatis and is the leading infectious cause of blindness worldwide. New serological assays for C trachomatis could facilitate improved understanding of C trachomatis epidemiology and prevention. C trachomatis serology offers a means of investigating the incidence of chlamydia infection and might be developed as a biomarker of scarring sequelae, such as pelvic inflammatory disease. Therefore, serological assays have potential as epidemiological tools to quantify unmet need, inform service planning, evaluate interventions including screening and treatment, and to assess new vaccine candidates. However, questions about the performance characteristics and interpretation of C trachomatis serological assays remain, which must be addressed to advance development within this field. In this Personal View, we explore the available information about C trachomatis serology and propose several priority actions. These actions involve development of target product profiles to guide assay selection and assessment across multiple applications and populations, establishment of a serum bank to facilitate assay development and evaluation, and development of technical and statistical methods for assay evaluation and analysis of serological findings. The field of C trachomatis serology will benefit from collaboration across the public health community to align technological developments with their potential applications.

CRISPR‐Cas system for biomedical diagnostic platforms

“…The chlamydiae, stain Gram‐negative with an ovoid shape, are bacterial phylum and class whose members are obligate intracellular bacteria 77 . Chlamydia, caused by Chlamydia trachomatis ( C. trachomatis ), is the universal sexually transmitted disease of bacteria in the world, affecting millions of people each year 78 .…”

Prevalence and persistence ofChlamydia trachomatis-specific antibodies after occasional and recurrent infections

“…Chlamydia trachomatis is a small, obligate intracellular pathogen that induces an antigen-specific immune response in an infected host. C. trachomatis serology is a useful tool with which to quantify the prevalence and incidence of chlamydia infection 1 2. In Finland, as in many countries, chlamydia surveillance is based on the reporting of current infections using a nucleic acid amplification test (NAAT).…”

“…Lack of information on the number of patients tested results in underestimation of the true incidence of chlamydia. Knowledge of population-level chlamydia prevalence and incidence is crucial for optimal screening and treatment services and an evaluation of the impact of chlamydia control interventions 1 3 . C. trachomatis serology could potentially be used as a screening test in an infertility work-up to estimate the likelihood of tubal factor infertility (TFI) and minimise delays performing further investigations and treatment 4–6.…”

“…Serology can also be used to estimate the population excess fraction of TFI and ectopic pregnancies. These estimates are useful when contemplating the need and cost-effectiveness of control interventions 1 7…”

The Gynecologic Health Consequences of Chlamydia trachomatis Infection in Military Servicewomen

“…Peripheral biomarkers for monitoring the course of CT infection and for the early detection of tubal pathology would be particularly beneficial in assessing the cost-effectiveness of control mechanisms. 116…”