{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,7,2]],"date-time":"2026-07-02T18:29:46Z","timestamp":1783016986547,"version":"3.54.6"},"reference-count":23,"publisher":"BMJ","license":[{"start":{"date-parts":[[2026,7,2]],"date-time":"2026-07-02T00:00:00Z","timestamp":1782950400000},"content-version":"unspecified","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"DOI":"10.13039\/501100001713","name":"European and Developing Countries Clinical Trials Partnership","doi-asserted-by":"publisher","award":["SP.2011.41304.038"],"award-info":[{"award-number":["SP.2011.41304.038"]}],"id":[{"id":"10.13039\/501100001713","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/501100001322","name":"South African Medical Research Council","doi-asserted-by":"publisher","award":["2017-2020"],"award-info":[{"award-number":["2017-2020"]}],"id":[{"id":"10.13039\/501100001322","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["bmj.com"],"crossmark-restriction":true},"short-container-title":["Sex Transm Infect"],"accepted":{"date-parts":[[2026,6,16]]},"abstract":"<jats:sec>\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>\n                      Adolescent girls and young women (AGYW) in sub-Saharan Africa are disproportionately affected by\n                      <jats:italic>Chlamydia trachomatis<\/jats:italic>\n                      (CT) infections, a leading cause of pelvic inflammatory disease, infertility and increased HIV susceptibility. CT-induced genital inflammation disrupts mucosal barriers and activates HIV target cells, compounding immunological risks. We investigated CT infection in AGYW from two South African regions, focusing on genital inflammation and immune activation.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>\n                      An observational cohort of 298 sexually active AGYW (aged 16\u201322 years) from Cape Town and Johannesburg was enrolled. Participants in Johannesburg attended one visit, while those in Cape Town were followed longitudinally (6\u20138 months). Cytokine profiling of cervicovaginal samples assessed inflammatory responses, while cervical cytobrush-derived CD4+ T cells were analysed for CD38, Ki67 and C-C chemokine receptor type 5 expression. CT\n                      <jats:italic>ompA<\/jats:italic>\n                      genotyping examined strain diversity.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>CT prevalence was 2.4-times higher in Cape Town (41.6%) than Johannesburg (17.4%). CT infection was associated with upregulated interleukin (IL)-1\u03b2, IL-6 and tumour necrosis factor (TNF)-\u03b1, with responses appearing stronger in Johannesburg, although low CT cases at this site limited regional comparisons. Genotyping suggested regional variation: genovar D, predominant in Cape Town, was associated with lower interferon (IFN)-\u03b3 concentrations, whereas genovar E, more common in Johannesburg, was associated with higher IFN-\u03b3 concentrations. AGYW with CT infection across multiple visits did not exhibit elevated genital tract cytokine levels compared with those infected at a single visit. However, they showed increased activated cervical CD4+ T cells.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>CT-associated immune responses in AGYW appear to reflect a combination of pathogen diversity, regional context and host immune history.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1136\/sextrans-2025-056900","type":"journal-article","created":{"date-parts":[[2026,7,2]],"date-time":"2026-07-02T17:29:03Z","timestamp":1783013343000},"page":"sextrans-2025-056900","update-policy":"https:\/\/doi.org\/10.1136\/crossmarkpolicy","source":"Crossref","is-referenced-by-count":0,"title":["Cervicovaginal inflammation and HIV target cell activation in adolescent girls and young women with\n                    <i>Chlamydia trachomatis<\/i>\n                    infections"],"prefix":"10.1136","author":[{"given":"Smritee","family":"Dabee","sequence":"first","affiliation":[{"name":"Division of Medical Virology, Department of Pathology, University of Cape Town, Observatory, South Africa"},{"name":"The University of British Columbia Faculty of Medicine, Vancouver, British Columbia, Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Shaun","family":"Barnabas","sequence":"additional","affiliation":[{"name":"Division of Medical Virology, Department of Pathology, University of Cape Town, Observatory, South Africa"},{"name":"Department of Medicine, Desmond Tutu HIV Centre, University of Cape Town, Cape Town, South Africa"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Brian","family":"Kullin","sequence":"additional","affiliation":[{"name":"Division of Medical Virology, Department of Pathology, University of Cape Town, Observatory, South Africa"},{"name":"DST-NRF CAPRISA Centre of Excellence in HIV Prevention, University of Cape Town, Rondebosch, South Africa"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Bart","family":"Versteeg","sequence":"additional","affiliation":[{"name":"Knowledge Institute of the Dutch Association of Medical Specialists, Utrecht, The Netherlands"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Nonhlanhla","family":"Mkhize","sequence":"additional","affiliation":[{"name":"National Institute for Communicable Diseases, Centre for HIV and STIs, National Health Laboratory Service, Johannesburg, South Africa"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-9800-491X","authenticated-orcid":false,"given":"Etienne","family":"Muller","sequence":"additional","affiliation":[{"name":"National Institute for Communicable Diseases, Centre for HIV and STIs, National Health Laboratory Service, Johannesburg, South Africa"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Venessa","family":"Maseko","sequence":"additional","affiliation":[{"name":"National Institute for Communicable Diseases, Centre for HIV and STIs, National Health Laboratory Service, Johannesburg, South Africa"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-5534-8392","authenticated-orcid":false,"given":"David A","family":"Lewis","sequence":"additional","affiliation":[{"name":"Western Sydney Sexual Health Centre, Western Sydney Local Health District, Wentworthville, New South Wales, Australia"},{"name":"Sydney Infectious Diseases Institute & Sydney Medical School Westmead, The University of Sydney, Sydney, New South Wales, Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Janan","family":"Dietrich","sequence":"additional","affiliation":[{"name":"Perinatal HIV Research Unit, University of the Witwatersrand Johannesburg Faculty of Health Sciences, Johannesburg, South Africa"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Glenda","family":"Gray","sequence":"additional","affiliation":[{"name":"Perinatal HIV Research Unit, University of the Witwatersrand Johannesburg Faculty of Health Sciences, Johannesburg, South Africa"},{"name":"South African Medical Research Council, Tygerberg, South Africa"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-3372-9506","authenticated-orcid":false,"given":"Katherine","family":"Gill","sequence":"additional","affiliation":[{"name":"Department of Medicine, Desmond Tutu HIV Centre, University of Cape Town, Cape Town, South Africa"},{"name":"University of Cape Town Institute of Infectious Disease and Molecular Medicine, Rondebosch, South Africa"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-0755-4386","authenticated-orcid":false,"given":"Linda-Gail","family":"Bekker","sequence":"additional","affiliation":[{"name":"Department of Medicine, Desmond Tutu HIV Centre, University of Cape Town, Cape Town, South Africa"},{"name":"University of Cape Town Institute of Infectious Disease and Molecular Medicine, Rondebosch, South Africa"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Musalula","family":"Sinkala","sequence":"additional","affiliation":[{"name":"University of Cape Town Institute of Infectious Disease and Molecular Medicine, Rondebosch, South Africa"},{"name":"Computational Biology Unit, Department of Integrative Biomedical Sciences, University of Cape Town, Observatory, South Africa"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Darren P","family":"Martin","sequence":"additional","affiliation":[{"name":"University of Cape Town Institute of Infectious Disease and Molecular Medicine, Rondebosch, South Africa"},{"name":"Computational Biology Unit, Department of Integrative Biomedical Sciences, University of Cape Town, Observatory, South Africa"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-4897-4261","authenticated-orcid":false,"given":"Sylvia M","family":"Bruisten","sequence":"additional","affiliation":[{"name":"Department of Infectious Diseases, Public Health Service of Amsterdam, Amsterdam, The Netherlands"},{"name":"Academic Medical Center, Amsterdam Infection and Immunity Institute, University of Amsterdam, Amsterdam, The Netherlands"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Heather B","family":"Jaspan","sequence":"additional","affiliation":[{"name":"University of Cape Town Institute of Infectious Disease and Molecular Medicine, Rondebosch, South Africa"},{"name":"Seattle Children\u2019s Research Institute, Seattle, Washington, 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Chlamydia and its immune evasion strategies. 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