[Question #384] Chlamydia Forever?

34 months ago

Hello.

I recently became very concerned (and quite obsessed) after reading about a new study published in the journal called "Infection and Immunity" written by Roger G. Rank, Ph.D. I am concerned that I will ALWAYS be at risk for chlamydia no matter how safe I am or how many times I am treated. Can chlamydia survive in the stomach even after its been eradicated from the cervix, ultimately re-infecting myself without sexual contact? Thank you for your help!

Sincerely,

Carrie

Edward W. Hook M.D.
Edward W. Hook M.D.
34 months ago
Welcome to the Forum. Dr. Rank is a friend and colleague.  His studies are conducted in guinea pigs using strains of chlamydia which, while in some ways similar to Chlamydia trachomatis, do not infect humans.  His data on the possibility of the gastrointestinal tract serving as a reservoir for persistent chlamydial infection do not have a known parallel in humans.  there are no data that the infection persists despite treatment in humans.  There are no data suggesting that chlamydia infect the upper genital tract of humans or that people can re-infect themselves. Please do not worry.  EWH
---
34 months ago

Good morning, Dr. Hook

Thank you for such a quick reply. I began researching chlamydia when I began to suspect that my treatment was not working. I have been back and forth multiple times in the past 6 months for treatment of chlamydia. I've had positive and negative results. My partner was also treated, but at different times. I will be honest, we did not wait the recommended two weeks to have sex, but we did use a condom each time. I came to the conclusion that I am either very unlucky or the medication wasn't working properly. I've only ever been given the single dose of Azithromycin. I was treated again on 12/21/15. He will be getting tested tomorrow and will have results next week. I am sticking to my guns this time. Absolutely, no sex of any kind until 2 weeks after he's been treated which would be no sooner than the end of January. Even after that, I plan to use condoms until I get re-tested. When do you recommend I would be able to re-test in order to achieve accurate results? Thanks again!

Carrie

Edward W. Hook M.D.
Edward W. Hook M.D.
34 months ago

There are a handful of cases in which persons (or couples) have failed chlamydia infection doe to chlamydia resistant to azithromycin.  Such cases however are VERY rare and if you and your partner have not been successful in efforts to make sure that you have both been treated without sex in the interval between one person's treatment and treatment of the other partner, it becomes quite hard to be sure what is going on.  To be entirely sure, I would:

1. Make sure you are both treated with doxycycline, 100 mg by mouth twice daily AND that you both take all of your medicine.  (There was a paper published last week that suggests that doxycycline is a tiny bit better than azithromycin for chlamydia (but ONLY if people take all doses of the medication).

2.  Abstain from sex until you have both completed therapy (or if you are treated with azithromycin, until at least a week after treatment).

3., Both of you should be tested again for chlamydia, at least two and preferably three weeks after treatment. 

I hope this information is helpful  EWH

---
34 months ago

Hi Doctor!

I would like to ask my last question. My partner got his results back today, and he is/was negative for chlamydia (He was treated the same day he was tested since I had already tested positive). How in the world is it possible that I tested positive and he tested negative when we had been having lots of unprotected sex? Thank you! I still plan to get re-tested in a few weeks. This situation still has me worried (especially now) that Dr. Rank's study could relate to humans. =( Thanks in advance!


Edward W. Hook M.D.
Edward W. Hook M.D.
34 months ago
STI transmission is a function of probability with transmission occurring on only a fraction of exposures.  If your partner had not taken antibiotics earlier for some reason, then he was lucky not to have been infected.  Further, while you and your partner have been working to sort this out, you report that you used condoms at least some of the time.  While not perfect, condoms greatly reduce the risk for infection from any given exposure.  Hope this helps. EWH
---