Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
. 2021 Oct 20;73(8):1507-1516.
doi: 10.1093/cid/ciab506.

High Plasmid Gene Protein 3 (Pgp3) Chlamydia trachomatis Seropositivity, Pelvic Inflammatory Disease, and Infertility Among Women, National Health and Nutrition Examination Survey, United States, 2013-2016

Gloria E Anyalechi  1 , Jaeyoung Hong  1 , Damien C Danavall  1 , Diana L Martin  2 , Sarah E Gwyn  2 , Patrick J Horner  3 , Brian H Raphael  1 , Robert D Kirkcaldy  1 , Ellen N Kersh  1 , Kyle T Bernstein  1
Affiliations

High Plasmid Gene Protein 3 (Pgp3) Chlamydia trachomatis Seropositivity, Pelvic Inflammatory Disease, and Infertility Among Women, National Health and Nutrition Examination Survey, United States, 2013-2016

Gloria E Anyalechi et al. Clin Infect Dis. .

Abstract

Background: Chlamydia trachomatis causes pelvic inflammatory disease (PID) and tubal infertility. Plasmid gene protein 3 antibody (Pgp3Ab) detects prior chlamydial infections. We evaluated for an association of high chlamydial seropositivity with sequelae using a Pgp3Ab multiplex bead array (Pgp3AbMBA).

Methods: We performed chlamydia Pgp3AbMBA on sera from women 18-39 years old participating in the 2013-2016 National Health and Nutrition Examination Survey (NHANES) with urine chlamydia nucleic acid amplification test results. High chlamydial seropositivity was defined as a median fluorescence intensity (MFI ≥ 50 000; low-positive was MFI > 551-<50 000. Weighted US population high-positive, low-positive, and negative Pgp3Ab chlamydia seroprevalence and 95% confidence intervals (CI) were compared for women with chlamydial infection, self-reported PID, and infertility.

Results: Of 2339 women aged 18-39 years, 1725 (73.7%) had sera, and 1425 were sexually experienced. Overall, 104 women had high positive Pgp3Ab (5.4% [95% CI 4.0-7.0] of US women); 407 had lowpositive Pgp3Ab (25.1% [95% CI 21.5-29.0]), and 914 had negative Pgp3Ab (69.5% [95% CI 65.5-73.4]). Among women with high Pgp3Ab, infertility prevalence was 2.0 (95% CI 1.1-3.7) times higher than among Pgp3Ab-negative women (19.6% [95% CI 10.5-31.7] versus 9.9% [95% CI 7.7-12.4]). For women with low Pgp3Ab, PID prevalence was 7.9% (95% CI 4.6-12.6) compared to 2.3% (95% CI 1.4-3.6) in negative Pgp3Ab.

Conclusions: High chlamydial Pgp3Ab seropositivity was associated with infertility although small sample size limited evaluation of an association of high seropositivity with PID. In infertile women, Pgp3Ab may be a marker of prior chlamydial infection.

Keywords: chlamydia serology; reproductive sequelae; seroprevalence; sexually transmitted infection.

PubMed Disclaimer

Conflict of interest statement

Potential conflicts of interest. The authors: No reported conflicts of interest. All authors have submitted the ICMJE Form for Disclosure of Potential Conflicts of Interest. Conflicts that the editors consider relevant to the content of the manuscript have been disclosed.

Figures

Figure 1.
Figure 1.
Women included in final sample of 1425 women aged 18–39 years with available chlamydia nucleic acid amplification test result, reported sexual experience, and available chlamydia serology result, National Health and Nutrition Examination Survey 2013–2016.
See this image and copyright information in PMC

References

    1. Centers for Disease Control and Prevention. Sexually transmitted disease surveillance 2018. Atlanta: U.S. Department of Health and Human Services, 2019.
    1. Petersen MR, Patel EU, Grabowski MK, Gaydos CA, Quinn TC, Tobian AAR. Seroprevalence of Chlamydia trachomatis among female adults in the United States: the National Health and Nutrition Examination Surveys. Clin Infect Dis 2020. doi:10.1093/cid/ciaa1879. - DOI - PMC - PubMed
    1. Oakeshott P, Kerry S, Aghaizu A, et al. Randomised controlled trial of screening for Chlamydia trachomatis to prevent pelvic inflammatory disease: the POPI (prevention of pelvic infection) trial. BMJ 2010; 340:c1642. - PMC - PubMed
    1. Weström L, Joesoef R, Reynolds G, Hagdu A, Thompson SE. Pelvic inflammatory disease and fertility: a cohort study of 1,844 women with laparoscopically verified disease and 657 control women with normal laparoscopic results. Sex Transm Dis 1992; 19:185–92. - PubMed
    1. Horner PJ, Wills GS, Reynolds R, et al. Effect of time since exposure to Chlamydia trachomatis on chlamydia antibody detection in women: a cross-sectional study. Sex Transm Infect 2013; 89:398–403. - PubMed

Publication types