{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,10]],"date-time":"2026-10-10T06:40:41Z","timestamp":1791614441117,"version":"4.3.4"},"reference-count":34,"publisher":"BMJ","issue":"7","funder":[{"DOI":"10.13039\/501100001826","name":"ZonMw","doi-asserted-by":"publisher","award":["50-53000-98-109"],"award-info":[{"award-number":["50-53000-98-109"]}],"id":[{"id":"10.13039\/501100001826","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["bmj.com"],"crossmark-restriction":true},"short-container-title":["Sex Transm Infect"],"accepted":{"date-parts":[[2020,1,28]]},"published-print":{"date-parts":[[2020,11]]},"abstract":"<jats:sec><jats:title>Objectives<\/jats:title><jats:p>Spontaneous clearance of<jats:italic>Chlamydia trachomatis<\/jats:italic>(CT) infections can occur between diagnosis and treatment. We followed CT patients to assess clearance using a conventional definition (no total CT-DNA, assessed by routine quantitative PCR methods) and a definition accounting for viability, assessed by viability PCR testing.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>Three outpatient STI clinics included CT-diagnosed women (The Netherlands, 2016\u20132017, FemCure study); participants had vaginal CT (vCT) and rectal CT (rCT) (group A: n=155), vCT and were rectally untested (group B: n=351), single vCT (group C: n=25) or single rCT (group D: n=29). Follow-up (median interval 9 days) vaginal and rectal samples underwent quantitative PCR testing (detecting total CT-DNA). When PCR positive, samples underwent V-PCR testing to detect \u2018viable CT\u2019 (CT-DNA from intact CT organisms; V-PCR positive). \u2018Clearance\u2019 was the proportion PCR-negative patients and \u2018clearance of viable CT\u2019 was the proportion of patients testing PCR negative or PCR positive but V-PCR negative. We used multivariable logistic regression analyses to assess diagnosis group (A\u2013D), age, days since initial CT test (diagnosis) and study site (STI clinic) in relation to clearance and clearance of viable CT.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>Clearance and clearance of viable CT at both anatomic sites were for (A) 0.6% and 3.9%; (B) 5.4% and 9.4%; (C) 32.0% and 52.0% and (D) 27.6% and 41.4%, respectively. In multivariate analyses, women with single infections (groups C and D) had higher likelihood of clearance than women concurrently infected with vCT and rCT (p&lt;0.001).<\/jats:p><jats:p>Of rectally untested women (group B), 76.9% had total CT-DNA and 46.7% had viable CT (V-PCR positive) at the rectal site.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusions<\/jats:title><jats:p>Of untreated female vCT patients who had CT also at the rectal site, or who were rectally untested, only a small proportion cleared CT (in fact many had viable CT) at their follow-up visit (median 9 days). Among single site infected women clearance was much higher.<\/jats:p><\/jats:sec><jats:sec><jats:title>Trial registration number<\/jats:title><jats:p><jats:ext-link xmlns:xlink=\"http:\/\/www.w3.org\/1999\/xlink\" ext-link-type=\"clintrialgov\" xlink:href=\"NCT02694497\">NCT02694497<\/jats:ext-link>.<\/jats:p><\/jats:sec>","DOI":"10.1136\/sextrans-2019-054267","type":"journal-article","created":{"date-parts":[[2020,2,17]],"date-time":"2020-02-17T22:19:43Z","timestamp":1581977983000},"page":"541-548","update-policy":"https:\/\/doi.org\/10.1136\/crossmarkpolicy","source":"Crossref","is-referenced-by-count":20,"title":["Spontaneous clearance of<i>Chlamydia trachomatis<\/i>accounting for bacterial viability in vaginally or rectally infected women (FemCure)"],"prefix":"10.1136","volume":"96","clinical-trial-number":[{"clinical-trial-number":"nct02694497","registry":"10.18810\/clinical-trials-gov"}],"author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-4896-758X","authenticated-orcid":false,"given":"Nicole H T M","family":"Dukers-Muijrers","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-5521-0521","authenticated-orcid":false,"given":"Kevin J H","family":"Janssen","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Christian J P A","family":"Hoebe","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-1236-6224","authenticated-orcid":false,"given":"Hannelore M","family":"G\u00f6tz","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Maarten F","family":"Schim van der Loeff","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Henry J C","family":"de Vries","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-4897-4261","authenticated-orcid":false,"given":"Sylvia M","family":"Bruisten","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Petra F G","family":"Wolffs","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"239","published-online":{"date-parts":[[2020,2,17]]},"reference":[{"key":"2024092304250617000_96.7.541.1","doi-asserted-by":"publisher","DOI":"10.1016\/S1473-3099(17)30310-9"},{"key":"2024092304250617000_96.7.541.2","doi-asserted-by":"publisher","DOI":"10.1016\/S1473-3099(12)70161-5"},{"key":"2024092304250617000_96.7.541.3","doi-asserted-by":"publisher","DOI":"10.1086\/652395"},{"key":"2024092304250617000_96.7.541.4","doi-asserted-by":"publisher","DOI":"10.1136\/sextrans-2018-053778"},{"key":"2024092304250617000_96.7.541.5","doi-asserted-by":"crossref","first-page":"1517","DOI":"10.1093\/cid\/ciz429","article-title":"Chlamydia trachomatis and the risk of pelvic inflammatory disease, ectopic pregnancy, and female infertility: a retrospective cohort study among primary care patients","volume":"69","author":"den Heijer","year":"2019","journal-title":"Clin Infect Dis"},{"key":"2024092304250617000_96.7.541.6","doi-asserted-by":"publisher","DOI":"10.1086\/652402"},{"key":"2024092304250617000_96.7.541.7","doi-asserted-by":"publisher","DOI":"10.1086\/428287"},{"key":"2024092304250617000_96.7.541.8","doi-asserted-by":"crossref","first-page":"12","DOI":"10.1258\/095646202762226092","article-title":"The natural course of asymptomatic Chlamydia trachomatis infections: 45% clearance and no development of clinical PID after one-year follow-up","volume":"13 Suppl 2","author":"Morr\u00e9","year":"2002","journal-title":"Int J STD AIDS"},{"key":"2024092304250617000_96.7.541.9","doi-asserted-by":"publisher","DOI":"10.1097\/OLQ.0b013e318151497d"},{"key":"2024092304250617000_96.7.541.10","doi-asserted-by":"publisher","DOI":"10.1097\/00007435-200204000-00002"},{"key":"2024092304250617000_96.7.541.11","doi-asserted-by":"publisher","DOI":"10.1097\/01.AOG.0000153533.13658.c2"},{"key":"2024092304250617000_96.7.541.12","doi-asserted-by":"publisher","DOI":"10.1093\/infdis\/jit094"},{"key":"2024092304250617000_96.7.541.13","doi-asserted-by":"publisher","DOI":"10.1136\/sextrans-2018-053825"},{"key":"2024092304250617000_96.7.541.14","doi-asserted-by":"publisher","DOI":"10.1097\/OLQ.0b013e3181b5f15d"},{"key":"2024092304250617000_96.7.541.15","doi-asserted-by":"crossref","DOI":"10.1371\/journal.pone.0165920","article-title":"Viability-PCR shows that NAAT detects a high proportion of DNA from non-viable Chlamydia trachomatis","volume":"11","author":"Janssen","year":"2016","journal-title":"PLoS One"},{"key":"2024092304250617000_96.7.541.16","doi-asserted-by":"crossref","unstructured":"Janssen KJH , Wolffs P , Lucchesi M , et al . 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