NATURAL-HISTORY OF GENITAL AND ALLIED CHLAMYDIAL INFECTIONS

In many societies, approximately 5% to 15% of the sexually active population is infected by Chlamydia trachomatis, although a tendency towards a decrease in the prevalence and incidence of genital infections by this agent has been registered in a number of countries. The use of noninvasive methods for screening, ie, testing of voided urine, has confirmed that men are a neglected reservoir for infections by C. trachomatis. Novel means of diagnosing chlamydial infection, eg, by amplified (polymerase chain reaction techniques) detection of chlamydial antigen in body fluids and biopsy material, as well as in histologic sections, has opened up new possibilities of studying the natural history of chlamydial infections. Studies of the mechanism behind the killing of chlamydial organisms in the host, eg, the role of cytokines and other nonimmunologic principles, as well as the study of the humoral and cell-mediated immune response, have also increased knowledge on the natural history of C. trachomatis infection. Several recent studies have confirmed the important role of C. trachomatis in infertility, ectopic pregnancy, and neonatal infections.