From the University of Maryland School of Medicine, Baltimore, MD.
Duke Human Vaccine Institute and Department of Medicine, Duke University School of Medicine, Durham, NC.
Sex Transm Dis. 2024 Feb 1;51(2):112-117. doi: 10.1097/OLQ.0000000000001905. Epub 2023 Nov 25.
Chlamydia trachomatis (CT) is the most commonly reported sexually transmitted infection in the United States. Untreated urogenital infection in women can result in adverse sequelae such as pelvic inflammatory disease and infertility. Despite national screening and treatment guidelines, rates continue to rise; because most infections are asymptomatic, the actual prevalence of CT infection is likely significantly higher than reported. Spontaneous clearance of CT in women (in the absence of antibiotic treatment) has been described in multiple epidemiologic studies. Given the serious consequences and high prevalence of CT infection, there is growing interest in understanding this phenomenon and factors that may promote CT clearance in women. Spontaneous CT clearance is likely the result of complex interactions between CT, the host immune system, and the vaginal microbiota (i.e., the communities of bacteria inhabiting the vagina), which has been implicated in CT acquisition. Herein, we briefly review current literature regarding the role of each of these factors in spontaneous CT clearance, identify knowledge gaps, and discuss future directions and possible implications for the development of novel interventions that may protect against CT infection, facilitate clearance, and prevent reproductive sequelae.
沙眼衣原体（CT）是美国最常报告的性传播感染。未经治疗的女性泌尿生殖系统感染可导致不良后果，如盆腔炎和不孕。尽管有国家筛查和治疗指南，但感染率仍在上升；因为大多数感染是无症状的，CT 感染的实际流行率可能远高于报告的水平。在多个流行病学研究中都描述了女性 CT 的自发清除（无抗生素治疗）。鉴于 CT 感染的严重后果和高流行率，人们越来越关注了解这一现象以及可能促进女性 CT 清除的因素。自发的 CT 清除可能是 CT、宿主免疫系统和阴道微生物群（即栖息在阴道中的细菌群落）之间复杂相互作用的结果，这与 CT 的获得有关。在此，我们简要回顾了目前关于这些因素在自发 CT 清除中的作用的文献，确定了知识空白，并讨论了未来的方向和可能对开发新的干预措施的影响，这些措施可能有助于预防 CT 感染、促进清除和预防生殖系统后遗症。
