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P172 Chlamydia Trachomatis Seropositivity by Age Among Women in Uganda and Zimbabwe

Wednesday, March 14, 2012
Hyatt Exhibit Hall
Rachel Gorwitz, MD, MPH1, Barbara Van Der Pol, PhD, MPH2, Cynthia Kwok, MSPH3, Sami L. Gottlieb, MD, MSPH1, Charles Morrison, PhD3, Robert E. Johnson, MD, MPH1, John Papp, PhD1, Lauri Markowitz, MD1 and Fujie Xu, MD, PhD1, 1Division of STD Prevention, CDC, Atlanta, GA, 2Indiana University, Bloomington, IN, 3FHI 360, Durham, NC

  

Background:  Chlamydia trachomatis (CT) serum IgG antibodies, if they develop consistently and persist, could provide evidence of past infection for epidemiologic studies. Antibodies to chlamydial heat shock protein 60 (cHSP60) have been associated with complicated infection and infertility. Few studies have evaluated persistence of either antibody.

Objectives:  To describe CT seropositivity by age.

Methods:  We tested serum samples from 1088 18-35 yr-old women seeking reproductive health services in Uganda and Zimbabwe who had negative CT PCR cervical swabs. IgG antibodies to CT major outer membrane protein (MOMP) and cHSP60 were assessed using Medac enzyme immunoassays. HSV-2 serostatus, a biomarker of sexual risk, was determined by type-specific HerpeSelect ELISA. Statistical associations were assessed using Mantel-Hanzel chi-square and extended chi-square for linear trend.

Results:  Anti-MOMP IgG prevalence was 36.0% (201/558) in Uganda and 11.9% (63/530) in Zimbabwe. Anti-MOMP IgG and HSV-2 seropositivity were associated (p<0.01) at both sites. In Uganda, anti-MOMP IgG seropositivity increased with age (31% in 18-24 yr-olds, 51% in 30-35 yrs-olds, p<0.001) as did HSV-2 seropositivity (39% in 18-24 yr-olds, 85% in 30-35 yr-olds, p<0.001). In Zimbabwe, anti-MOMP IgG seropositivity was not significantly associated with age (9% in 18-24 yr-olds, 12% in 30-35 yr-olds), while HSV-2 seropositivity was (45% in 18-24 yr-olds, 71% in 30-35 yr-olds, p<0.001). Among women with anti-MOMP IgG, cHSP60 seropositivity was 81% and 41% in Uganda and Zimbabwe, respectively, and trended downward with age in Zimbabwe (61% in 18-24 yr-olds, 29% in 30-35 yr-olds, p<0.05) but not Uganda.

Conclusions:  Seroprevalence of CT anti-MOMP IgG increased with age in only one site. A higher percentage of anti-MOMP IgG positive women in Uganda were cHSP60 positive, potentially indicating more severe infection.

Implications for Programs, Policy, and Research: Longitudinal assessments of correlates of seropositivity and antibody persistence are needed to determine utility of serologic assays in epidemiologic studies of CT infection and infertility.

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