Department of Epidemiology.
Department of Medicine, University of Washington, Seattle.
J Infect Dis. 2024 Jul 25;230(1):250-262. doi: 10.1093/infdis/jiae199.
Chlamydia trachomatis (CT) is a sexually transmitted infection that can lead to adverse reproductive health outcomes. CT prevalence estimates are primarily derived from screening using nucleic acid amplification tests (NAATs). However, screening guidelines in the United States only include particular subpopulations, and NAATs only detect current infections. In contrast, seroassays identify past CT infections, which is important for understanding the public health impacts of CT, including pelvic inflammatory disease and tubal factor infertility. Older seroassays have been plagued by low sensitivity and specificity and have not been validated using a consistent reference measure, making it challenging to compare studies, define the epidemiology of CT, and determine the effectiveness of control programs. Newer seroassays have better performance characteristics. This narrative review summarizes the "state of the science" for CT seroassays that have been applied in epidemiologic studies and provides practical considerations for interpreting the literature and employing seroassays in future research.
沙眼衣原体（CT）是一种性传播感染，可导致不良的生殖健康结局。CT 的流行率估计主要来自使用核酸扩增检测（NAAT）进行的筛查。然而，美国的筛查指南仅包括特定的亚人群，而 NAAT 仅检测当前的感染。相比之下，血清学检测可识别过去的 CT 感染，这对于了解 CT 的公共卫生影响很重要，包括盆腔炎和输卵管因素不孕。较旧的血清学检测一直存在敏感性和特异性低的问题，并且没有使用一致的参考测量方法进行验证，这使得比较研究、定义 CT 的流行病学以及确定控制计划的效果变得具有挑战性。较新的血清学检测具有更好的性能特征。本叙述性综述总结了已应用于流行病学研究的 CT 血清学检测的“科学现状”，并为解释文献和在未来研究中使用血清学检测提供了实用的考虑因素。
