[Question #2372] Chlamydia

43 months ago
I am sorry to be back here again for a totally unrelated question to the previous ones. I just need clarification on my chlamydia results. I know you advised me the blood test for chlamydia is unreliable but currently that's the only one I have access to. On 23 September 2016 I had sex with someone and suspected the condom might have come off at some point which I wasn't very sure. I took pep within 72 hours although I only took it for 3 weeks. On 31 October 2016 I did blood test for stis excluding hiv. All were negative. Both the chlamydia IgG and igm were negative. Last week I went and did another chlamydia and gonorrhea blood test. This time the chlamydia IgG was positive but igm was negative. I am really confused. Since I have the first test I have one one penetrative sex with condom outside my marriage in January/ February although I have had genital rubbing with my clothes on which I described in my previous post. All sex with my partner has been protected since September 2016. My question is did I test too early for my first chlamydia test after the exposure or I might have pick the chlamydia from the sex I had in January /February. If that's the case wouldn't the igm be positive. I went for the second chlamydia test because about two weeks I experienced pain when urinating for about 3 days so I wanted to be sure that I didn't pick anything from the lady friend I visited in her house where we engaged in genital rubbing albeit covered in my clothe. This positive chlamydia test makes me so worried as I believe I might have been exposed to bodily fluid at some point although I have been very careful. 

Edward W. Hook M.D.
Edward W. Hook M.D.
43 months ago
Welcome back to the Forum.  In preparing to answer your question I reviewed your earlier interactions with Dr. Handsfield and me, including your interaction with Dr. Handsfield a week ago (which is still open because we were waiting to hear from you about your HIV test result).  I agree with all that he said, including that there is no risk for STIs from the exposures you have reported, including your recent episode of genital rubbing while you had your pants on.  In an earlier interaction Dr. Handsfield warned you against blood tests for STIs such as chlamydia and gonorrhea, telling you that they are unreliable.  I repeat that. Our own research studies show that these tests are both insensitive and have a high rate of false positive results and we would NEVER recommend them for diagnosis of chlamydial infection.  I would urge you to ignore the result and, as Dr. Handsfield has already suggested, seek a urine test for chlamydia with one of the widely available nucleic acid amplification (sometimes called PCR) tests.  If you are still in the UK, these tests are widely available at GUM Clinics throughout the nation.

I hope this guidance is helpful to you.  I worry that you have chosen to not follow our earlier advice (apparently you have still not had a blood test for HIV either).  EWH
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43 months ago
Thank you for the reply. I will do a full sti test together with my wife when we are in the UK in August as I am currently working in Africa. 

Also I want to add that I also did a urine analysis test and everything was clear. Does such test show sti if any. Thank you. 

Edward W. Hook M.D.
Edward W. Hook M.D.
43 months ago
The results of the urinalysis are helpful but not definitive. The part of the urinalysis that is of interest is the white blood cell (WBC) test which, if positive, MIGHT suggest an infection.  Infections can occur without WBCs in the urine however so best to have the nucleic acid amplification test for chlamydia and gonorrhea that we have suggested.  I anticipate that the result will be negative.  EWH
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