Predictive Values of Serum Chlamydia trachomatis TroA and HtrA IgG Antibodies as Markers of Persistent Infection in the Detection of Pelvic Adhesions and Tubal Occlusion

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Rantsi, T.; Land, J.A.; Joki-Korpela, P.; Ouburg, S.; Hokynar, K.; Paavonen, J.; Tiitinen, A.; Puolakkainen, M. Predictive Values of Serum Chlamydia trachomatis TroA and HtrA IgG Antibodies as Markers of Persistent Infection in the Detection of Pelvic Adhesions and Tubal Occlusion. Microorganisms 2019, 7, 391.

Title: Predictive Values of Serum Chlamydia trachomatis TroA and HtrA IgG Antibodies as Markers of Persistent Infection in the Detection of Pelvic Adhesions and Tubal Occlusion
Author: Rantsi, Tiina; Land, Jolande A.; Joki-Korpela, Päivi; Ouburg, Sander; Hokynar, Kati; Paavonen, Jorma; Tiitinen, Aila; Puolakkainen, Mirja
Publisher: Multidisciplinary Digital Publishing Institute
Date: 2019-09-25
URI: http://hdl.handle.net/10138/305961
Abstract: <i>Chlamydia trachomatis</i> IgG antibody testing (CAT) has been used as a screening test for tubal factor infertility (TFI), but as the CAT is only a marker of a past exposure to <i>C. trachomatis</i> and not of late sequelae, the positive predictive value (PPV) of the test is low. The persistence of <i>C. trachomatis</i> in the upper genital tract has been suggested as one of the key mechanisms in the development of TFI. Serum antibodies against <i>C. trachomatis</i> TroA and HtrA, proteins expressed specifically during persistent infection, have been suggested as novel biomarkers for TFI diagnostics. We studied serum IgG antibody responses against <i>C. trachomatis</i> TroA, HtrA and MOMP in 79 subfertile women, of whom 28 had laparoscopically proven TFI. We confirmed that the accuracy of CAT in diagnosing TFI is low, whereas TroA IgG and HtrA IgG are more accurate tests in detecting tubal occlusion and pelvic adhesions. However, the sensitivity and negative predictive value (NPV) of TroA IgG and HtrA IgG are still too low to justify their use as a screening test in clinical practice. Individual immunogenetic profiles combined with TroA and HtrA antibody responses might identify women with the highest risk for developing late complications after <i>C. trachomatis</i> infection.


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