Persistence of Chlamydia trachomatis infection detected by polymerase chain reaction in untreated patients

Sex Transm Dis. 2002 Apr;29(4):196-200. doi: 10.1097/00007435-200204000-00002.


Background: Prior studies have used Chlamydia trachomatis culture methods to demonstrate both persistence and spontaneous clearance of genital C trachomatis infection.

Objective: To further assess the issue of persistence and spontaneous clearance of C trachomatis infection, untreated men and women were evaluated with repeated polymerase chain reaction (PCR) testing.

Methods: Ninety four untreated patients with a prior positive C trachomatis PCR test returning to the Denver Metro Sexually Transmitted Disease Clinic were retested by PCR.

Results: The median and range intervals from initial to follow-up testing were 9.0 (2-112) days for men and 10.0 (2-231) days for women. Repeated PCR tests were positive for 29 of 36 men (80.6%) and 45 of 58 women (77.6%). Persistent PCR positivity did not decrease with a longer testing interval. By multivariate analysis, independent predictors of a persistently positive PCR test included nonwhite ethnicity, an interval of more than 3 days since last sexual encounter before the initial test, and an initial PCR optical density value of greater than or equal to 3.0.

Conclusions: In the absence of treatment, a large majority of patients testing positive for C trachomatis by PCR are likely to remain positive for variable periods of time, increasing the risk of transmission and immune-mediated damage. A low initial optical density value and recent sexual contact may be markers for exposure that does not establish infection.

Publication types

  • Evaluation Study

MeSH terms

  • Adult
  • Cervix Uteri / microbiology
  • Chlamydia Infections / diagnosis*
  • Chlamydia Infections / epidemiology*
  • Chlamydia Infections / microbiology
  • Chlamydia Infections / urine
  • Chlamydia trachomatis / genetics
  • Chlamydia trachomatis / isolation & purification
  • Colorado / epidemiology
  • Community Health Centers
  • DNA, Bacterial / genetics
  • False Negative Reactions
  • Female
  • Female Urogenital Diseases / diagnosis*
  • Female Urogenital Diseases / epidemiology*
  • Female Urogenital Diseases / microbiology
  • Female Urogenital Diseases / urine
  • Humans
  • Male
  • Male Urogenital Diseases*
  • Polymerase Chain Reaction / standards


  • DNA, Bacterial