[Question #6506] Chlamydia

67 months ago

Hello Dr,

I had a std panel screening test done yesterday, Chlamydia came back weak positive according to the Dr, all the rest negative.

I assume the test was a antibody test for Chlamydia as only blood was drawn.

I have had 2 other std panel screening tests in past couple of years done with another Dr and these test's came back "negative" in the sense that there was a antibody count but within the normal range but the antibody count on these 2 test's did differ from each other in the sense the antibody count second time was lower than first test. The Dr back then told me it was probably related to a Chlamydia that is a respiratory strain and that i breathed it in at one stage but not enough to get sick and this is what the test picked up?

Now the test from yesterday which is 3rd test couple of years after above mentioned test's is weak positive that is all i know the Dr who is treating me now just told me the results via text message and said we will speak next week.

I have been diagnosed with cpps/chronic prostatitis can the above be connected?

Your opinion/advice will appreciated.

67 months ago

Some additional info that might be relevant, i checked now and see that i did do a urine pcr back then before the antibody test's and it was negative and last year the urologist who is treating me for cpps did a semen culture and nothing was mention of Chlamydia there either......so only the antibody tests keep showing something....

Edward W. Hook M.D.

67 months ago

thanks for your post and the information you have provided. My advice would be to ignore your positive antibody test for Chlamydia. The commercially available test for antibodies to chlamydia is notoriously unreliable, being subject to both falsely positive and falsely negative results. In addition, the test may also cross react with antibodies to a strain of chlamydia called Chlamydia pneumoniae which causes respiratory tract infections. The only reliable test for active genitourinary chlamydial infections is the PCR test of the sort you mention which was negative.

You mention your CPPs/chronic prostatitis so I will add that I appreciate just how frustrating this syndrome can be. Please do not let this chlamydial antibody test send you down a "rabbit hole" EWH

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67 months ago

Thank you for the quick response! I will take Dr's advice on the chlamydia test.

The other test's i took were gonorrhoea, syphilis, hep c and herpes 1 &2(previous herpes test's also neg) all these were also antibody test's and it has been more than 90 days after my last sexual interaction when i took these test's, can i have confidence in these negative results?

Edward W. Hook M.D.

67 months ago

Sorry for not mentioning other STIs. The antibody test for gonorrhea is just as unreliable as the test for chlamydia. The herpes antibody test is better than the tests for gonorrhea and with negative tests and no history of lesions it is quite unlikely you have, or have ever had herpes. On the other hand, the test for syphilis is reliable and conclusive at his time. EWH
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67 months ago

Thank you Dr. If i was to test for chlamydia and gonorrhea would you say urine or swap pcr? Would urine pcr work for herpes 2 as well and if neg only tell me i dont have it in my urethra?

My wife of 13 years has herpes 1 and it looks like to date that i have not caught it yet anywhere can i chalk this up to the fact that we dont do anything when she has a breakout or have i just been lucky?

These are my final questions, thank you in advance!

Edward W. Hook M.D.

67 months ago

For testing for penile infection urine and swab tests are equally accurate and urine tests are less uncomfortable than swab tests. I would suggest the urine test.

Regarding your wife, I do not know the details of her infection but if it was diagnosed with a blood test, as was your experience, the blood test may be incorrect. Alternatively there are a number of relatively complex reasons why you have not experience herpes yourself. Either way, after 13 years, my advice would be to continue doing what you have been doing. Even if, for some reason you should acquire HSV-1 from her, as I suspect she will tell you, it is not a major problem to deal with.

I hope this information is helpful. As you know, and as per Forum guidelines, this thread will be closed shortly. Take care. EWH

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