[Question #8024] Questions about NAAT testing

49 months ago

Hello Doctors,

I have a few questions about GN and CHL NAAT testing.

I recently was retested and I'm awaiting my results. I'm retesting just to be sure that all is good but unfortunately I slipped up and had unprotected sex 4-5 times with an old BF who at one time gave me CHL. He insists he is clean but I need to know for my sanity. My results are pending.

My questions are:

1...if he was infected and we had unprotected sex 5 times, what are the chances he passed it along? I have ZERO symptoms by the way. But I will admit that my anxiety is high and I'm hyper sensitive. I just keep telling myself if I had symptoms they would persist and STD symptoms do not come and go!

2...when I did the NAAT test , I had urinated 50 minutes prior not realizing one hours is the standard. Is it too soon to have done the test? Also I did give first catch urine but basically filled the bottle. Did I give too much?? I read its only supposed to be 20-30ml but i probably gave 60-70ml. No one in the lab informed me.

3...I have been testing myself with UTI stripes the last few days and and have no signs of NITRATES and LEUKYCYTES. Not even a trace. Is this a good thing in my favor in your opinion. Even if I was asymptomatic, I would think there would be WBC in my urine.

4...just out of curiosity does the immune system naturally clear CHL and or GN over time in women and men and if so would you know the average timeline??

Truly appreciate this forum and all you do.

Edward W. Hook M.D.

49 months ago

Welcome back to the Forum. On this occasion I will be addressing your questions. In preparing to address your continuing concerns, I did review your earlier interaction with Dr. Handsfield and agree with his assessment and advice.

Regarding your concerns, it is reasonable to re-test after repeat exposures. In fact, the CDC recommends that persons with a positive test for chlamydia, gonorrhea, or trichomonas repeat their tests several months following initial diagnosis and treatment. This is done because these infections can be asymptomatic and multiple studies have shown that a person who has acquired one infection, is at risk for repeat infection, presumably at least in part due to re-infection by an asymptomatic partner. in response to your specific questions:

IF your partner was infected (if he was treated previously for the infection he gave to you, it is relatively unlikely that he was infected), with each exposure the risk for infection goes up. Following a single exposure to an infected partner the estimated risk for infection is 30-40% and this likelihood increases with additional exposure.

Sorry you were not informed but it is probably not a problem. Your test results at 50 minutes are almost certainly accurate. Currently available NAAAT tests for diagnosis of gonorrhea, chlamydia and trichomoniasis are amongst the most sensitive tests in all of medicine and are highly reliable. It is rare for them to miss an infection.

Yes, this is a good thing. Persons with urinary tract infections typically have positive tests for leukocytes and nitrates. For STI diagnosis these tests may or may not be positive. The NAAT test you were tested with is far more accurate.

4...just out of curiosity does the immune system naturally clear CHL and or GN over time in women and men and if so would you know the average timeline??

Yes, there are data to indicate that some of these infections do resolve without therapy over time. At 2-4 weeks about 20% of infections will resolve.

I hope that these replies are helpful. EWH

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49 months ago

Thank you for your response Dr. Hook

My follow up questions are as follows:

1) do symptoms of chlamydia come and go when first appear or are they persistent?

2)judging by your estimation of 30-40 per cent re infection the odds are in my favour that I never got reinfected after 5 encounters.

3) does the amount of urine matter when giving a sample for test? I mentioned I basically gave 60-80 ml as opposed to 20-30ml

4) are leukocytes present in a asymptotic infections done with a LET urine strip test?

Thank you for your kind consideration in advance.

Edward W. Hook M.D.

49 months ago

1. The majority of chlamydial infections are not symptomatic, particularly in women. When symptoms occur they tend to persist or worsen rather than come and go.

2. Trying to apply these numbers is not helpful. Rather believe your test results. if your tests results are negative, be confident you were not infected at the time you were tested.

3. Probably not

4. Leukocytes are often present even in asymptomatic infections

My sense is that you are overthinking this. Rather than worrying about leukocytes, nitrates of symptoms, just test using a NAAT test as you have done. If the test is negative, be confident you do not have chlamydial infection. EWH

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49 months ago

Thank you for your reply.

Good news...test results have come back and NEGATIVE for CHL and GN!

In conclusion, one final question please:

If you were the Dr. that ordered the NAAT test would you be confident with the NEG results knowing that I provided the sample 50 min as opposed to an hour min and I provided 80 ml as opposed to 30ml. Also knowing that I have no symptoms and no leukocytes in my UTI dip stick tests?

Keeping in mind also that I'm not currently sexually active.

Thank you in advance for the service provided! Truly helps educate.

Edward W. Hook M.D.

49 months ago

Thanks for sharing your test results. your tests prove that you were not infected. I would have complete confidence in the results and see no reason for further testing. The somewhat larger urine volume submitted for your test would not keep me from being confident in your test results. Time to put this al behind you.

As you know, we provide up to three responses for each client's questions. This is my 3rd response, thus this thread will be closed shortly. You are in the clear. Take care. EWH

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