Chlamydial Infection: A Clinical and Public Health Perspective (Issues in Infectious Diseases, Vol. 7)

Chlamydiae are obligate intracellular bacteria that cause one of the most common sexually transmitted infectious diseases in the world. The infection disproportionately impacts women and the highest prevalence of infection is found in adolescents. Most chlamydial infections are asymptomatic. Untreated infections are sources of further spread of infection and can lead to serious consequences including pelvic inflammatory disease, infertility and chronic pelvic pain. Chlamydial infections also increase a person’s susceptibility to HIV and other STDs. Featuring contributions by internationally recognized experts in epidemiology, infectious disease research and chlamydial biology, this book provides up-to-date reviews from a clinical and public health perspective on chlamydia epidemiology and control programs, genomics and pathogenicity, diagnosis, treatment, host immune responses, and the latest on the search for an effective vaccine. Also included are chapters on the impact of chlamydial infection on specific populations such as the lesbian, gay, bisexual and transgender community, and an update on the outbreak in Europe of the invasive chlamydial infection, lymphogranuloma venereum or LGV. This comprehensive publication is intended for clinicians, public health workers and scientists with interest in sexually transmitted diseases, medical microbiology, infectious diseases and clinical research. Cover 1 Front Matter 4 Contents 6 Introduction 8 A Short History of C. trachomatis 9 Biology and Clinical Syndromes of C. trachomatis 11 Acknowledgments 14 Disclaimer 14 References 15 Epidemiology and Prevention and Control Programs for Chlamydia 16 Abstract 16 Current Burden of Infection 16 Epidemiologic Trends 17 Importance and Challenges of Monitoring Sequelae of Infection 21 International Chlamydia Trends 22 Chlamydia Prevention and Control 22 Case Detection and Treatment 23 Screening for Prevention 23 Partner Services 26 Primary Prevention 27 Conclusion 28 References 28 Chlamydia trachomatis Pathogenicity and Disease 32 Abstract 32 Exposure and Infectivity 34 Survival within the Host Cell 38 Virulence Factors 41 The Immune Response 46 Host Genetic Susceptibility to Infection and Disease 51 References 54 Chlamydia trachomatis Genome Structure 68 Abstract 68 Chlamydia Genome Structure and Evolution 69 Variation in Genome Structure within C. trachomatis 73 Efforts to Develop Molecular Typing Strategies 77 Multilocus Sequence Typing 77 Strain Evolution and Emergence 77 Acknowledgements 80 References 80 Chlamydia trachomatis : Molecular Testing Methods 85 Abstract 85 Tests for C. trachomatis Screening 86 Serology 91 References 93 Treatment of Chlamydia trachomatis Infections 96 Abstract 96 Antimicrobial Susceptibility of C. Trachomatis 97 Treatment of C. trachomatis Infections in Adults and Adolescents 99 Treatment of Pregnant Women 100 Treatment of Lymphogranuloma Venereum 100 References 102 The Immunologic Response to Urogenital Infection 104 Abstract 104 Human Immune Response to Genital Chlamydia trachomatis Infection 104 Immunological Data from Animal Models of Genital Chlamydia Infection 106 The Adaptive Immune Response and Protective Host Immunity 109 The T Cell Response 109 IFN-γ-Dependent Cellular Immunity (iNOS) 110 IFN-γ-Independent Cellular Immunity (Plac8) 112 Cytokine Polarization 113 Antibody-Mediated Immunity 115 Summary of Adaptive Immunity 115 Innate Immune Response and Immunopathology 116 References 118 Chlamydia Vaccine Development 122 Abstract 122 Need for a Chlamydia Vaccine 122 Chlamydia Vaccine Design Requirements and Challenges 125 Potential Chlamydial Vaccine Candidates 128 Requirements of Delivery Systems for Efficacious Chlamydial Vaccines 130 New Paradigms and Strategies for Design and Delivery of Effective Chlamydial Vaccines 131 Conclusion 133 Acknowledgments 134 References 134 Maternal and Infant Chlamydia trachomatis Infections 138 Abstract 138 The Effect of Pregnancy on Chlamydia trachomatis Infection 138 The Effect of C. trachomatis Infection on Pregnancy 139 Postpartum Effects of C. trachomatis Infections 140 C. trachomatis Infections in Newborn Infants 140 Prevention and Control Strategies 142 References 146 Chlamydia trachomatis Infection amongSexual Minorities 149 Abstract 149 Women Who Have Sex with Women 150 Men Who Have Sex with Men 152 Lymphogranuloma Venereum 154 Conclusion 155 References 155 Lymphogranuloma Venereum: A Concise Outline of an Emerging Infection among Men Who Have Sex with Men 158 Abstract 158 Epidemiology 158 Clinical Presentation 159 Diagnosis 161 Treatment 162 Risk Factors in the Current Epidemic among MSM 162 Conclusions 162 Acknowledgements 163 References 163 Author Index 165 Subject Index 166 Back Cover 170 Epidemiology and prevention and control programs for chlamydia / C.L. Satterwhite, J.M. Douglas, Jr. Chlamydia trachomatis pathogenicity and disease / D. Dean Chlamydia trachomatis genome structure / T.E. Putman, D.D. Rockey Chlamydia trachomatis : molecular testing methods / C.A. Gaydos Treatment of chlamydia trachomatis infections / M.R. Hammerschlag The Immunologic Response to Urogenital Infection / R.M. Johnson, W. Geisler Chlamydia vaccine development / J.U. Igietseme, C.M. Black Maternal and infant chlamydia trachomatis infections / I.G.I.J.G. Rours, M.R. Hammerschlag Chlamydia trachomatis infection among sexual minorities / D. Singh, J.M. Marrazzo Lymphogranuloma venereum : a concise outline of an emerging infection among men who have sex with men / H.J.C. de Vries, S. Morré.