Chlamydial Pgp3 Seropositivity and Population-Attributable Fraction Among Women With Tubal Factor Infertility.

Autor:	Anyalechi GE; From the Division of STD Prevention, Centers for Disease Control and Prevention, Atlanta, GA., Hong J; From the Division of STD Prevention, Centers for Disease Control and Prevention, Atlanta, GA., Kirkcaldy RD; From the Division of STD Prevention, Centers for Disease Control and Prevention, Atlanta, GA., Wiesenfeld HC; University of Pittsburgh School of Medicine and Magee-Womens Research Institute, Pittsburgh, PA., Horner P; Population Health Sciences and National Institute for Health Research, Health Protection Research Unit in Behavioural Science and Evaluation in Partnership with Public Health England, University of Bristol, Bristol., Wills GS; Section of Infectious Diseases Jefferiss Research Trust Laboratories Wright-Fleming Institute, Faculty of Medicine, Imperial College London, St Mary's Campus, London, United Kingdom., McClure MO; Section of Infectious Diseases Jefferiss Research Trust Laboratories Wright-Fleming Institute, Faculty of Medicine, Imperial College London, St Mary's Campus, London, United Kingdom., Hammond KR; Alabama Fertility Specialists, Birmingham, AL., Haggerty CL; University of Pittsburgh Graduate School of Public Health Department of Epidemiology and Magee-Womens Research Institute, Pittsburgh, PA., Kissin DM; Division of Reproductive Health, Centers for Disease Control and Prevention, Atlanta, GA., Hook EW 3rd; Department of Medicine, University of Alabama at Birmingham, Birmingham, AL., Steinkampf MP; Alabama Fertility Specialists, Birmingham, AL., Bernstein K; From the Division of STD Prevention, Centers for Disease Control and Prevention, Atlanta, GA., Geisler WM; Department of Medicine, University of Alabama at Birmingham, Birmingham, AL.
Jazyk:	angličtina
Zdroj:	Sexually transmitted diseases [Sex Transm Dis] 2022 Aug 01; Vol. 49 (8), pp. 527-533. Date of Electronic Publication: 2021 Mar 31.
DOI:	10.1097/OLQ.0000000000001434
Abstrakt:	Background: Chlamydial infection is associated with tubal factor infertility (TFI); however, assessment of prior chlamydial infection and TFI is imperfect. We previously evaluated a combination of serological assays for association with TFI. We now describe the chlamydial contribution to TFI using a newer Chlamydia trachomatis Pgp3-enhanced serological (Pgp3) assay. Methods: In our case-control study of women 19 to 42 years old with hysterosalpingogram-diagnosed TFI (cases) and non-TFI (controls) in 2 US infertility clinics, we assessed possible associations and effect modifiers between Pgp3 seropositivity and TFI using adjusted odds ratios with 95% confidence intervals (CIs) stratified by race. We then estimated the adjusted chlamydia population-attributable fraction with 95% CI of TFI. Results: All Black (n = 107) and 618 of 620 non-Black women had Pgp3 results. Pgp3 seropositivity was 25.9% (95% CI, 19.3%-33.8%) for non-Black cases, 15.2% (95% CI, 12.3%-18.7%) for non-Black controls, 66.0% (95% CI, 51.7%-77.8%) for Black cases, and 71.7% (95% CI, 59.2%-81.5%) for Black controls. Among 476 non-Black women without endometriosis (n = 476), Pgp3 was associated with TFI (adjusted odds ratio, 2.6 [95% CI, 1.5-4.4]), adjusting for clinic, age, and income; chlamydia TFI-adjusted population-attributable fraction was 19.8% (95% CI, 7.7%-32.2%) in these women. Pgp3 positivity was not associated with TFI among non-Black women with endometriosis or among Black women (regardless of endometriosis). Conclusions: Among non-Black infertile women without endometriosis in these clinics, 20% of TFI was attributed to chlamydia. Better biomarkers are needed to estimate chlamydia TFI PAF, especially in Black women. Competing Interests: Conflict of Interest and Sources of Funding: The authors have no conflict of interest. This study was supported by Centers for Disease Control and Prevention, Prevention Research Centers grants (5U48DP001915 and 5U48DP001918) and National Institutes of Health, Sexually Transmitted Infections Clinical Trials group (contract HHSN27220130012I). (Copyright © 2021 American Sexually Transmitted Diseases Association. All rights reserved.)
Databáze:	MEDLINE
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