Antibody Testing in Estimating Past Exposure to Chlamydia trachomatis in The Netherlands Chlamydia Cohort Study

Bernice M. Hoenderboom*, Michelle E. van Willige, Jolande A. Land, Jolein Pleijster, Hannelore M. Gotz, Jan E. A. M. van Bergen, Nicole H. T. M. Dukers-Muijrers, Christian J. P. A. Hoebe, Birgit H. B. van Benthem, Servaas A. Morre

*Corresponding author for this work

Research output: Contribution to journalArticleAcademicpeer-review


The asymptomatic course of Chlamydia trachomatis (CT) infections can result in underestimated CT lifetime prevalence. Antibody testing might improve this estimate. We assessed CT antibody positivity and predictive factors thereof in the Netherlands Chlamydia Cohort Study. Women who had >= 1 CT Nucleic Acid Amplification Test (NAAT) in the study (2008-2011) and who provided self-reported information on NAATs were tested for CT major outer membrane protein specific IgG in serum (2016). CT antibody positivity was assessed and predictive factors were identified using multivariable logistic regressions, separately for CT-positive women (>= 1 positive NAAT or >= 1 self-reported positive CT test) and CT-negative women (negative by study NAAT and self-report). Of the 3,613 women studied, 833 (23.1%) were CT -positive. Among the CT-negative women, 208 (7.5%, 95% CI 6.5-8.5) tested positive for CT antibodies. This increased CT lifetime prevalence with 5.8% (95% CI 5.0-6.5). Among women with a CT-positive history, 338 (40.6%, 95% CI 38.5-44.1) tested positive. Predictive factors for antibody positivity related to lower social economic status, sexual risk behavior, multiple infections, higher body mass index, and non-smoking. CT antibody testing significantly increased the lifetime prevalence. Combining NAAT outcomes, self-reported positive tests, and antibody testing reduced misclassification in CT prevalence estimates.

Original languageEnglish
Article number442
Number of pages14
Issue number10
Publication statusPublished - Oct 2019


  • Chlamydia trachomatis
  • antibody testing
  • antibodies
  • chlamydia IgG
  • prevalence
  • RISK


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