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STDs (Expert Forum)
Chlamydia and antibody test - timing
Answered by
University of Washington
Seattle - WA
Welcome to the STD Forum, which is intended only for questions and support pertaining to sexually transmitted diseases other than HIV/AIDS, including chlamydia, gonorrhea, syphilis, human papillomavirus, genital warts, trichomonas, other vaginal infections, nongonoccal urethritis (NGU), cervicitis, molluscum contagiosum, chancroid, and pelvic inflammatory disease (PID). All questions will be answered by H. Hunter Handsfield, M.D. or Edward W Hook, MD.
Chlamydia and antibody test - timing
by AprilRain, Apr 26, 2006 12:00AM
I hope that you will be able to shed some light on my situation.
In mid 2004 I was tested for STDs and the results were negative for all STDs including chlamydia. Since that time I have not been sexually active until this year.
I started dating a girl at the beginning of March 2006. We both assured each other that we had been tested and are good. Her last test was in late 2005, and she represented that I am the only partner since that time.
In the beginning of April she traveled back to her home in another state. In a routine OBGYN examination a week later the doctor tested for STDs and chlamydia (via swab sample) came up positive. The doctor believes that I am the carrier because he also performed an “antibody”(?) test for chlamydia and she has not yet developed antibodies to the chlamydia infection. The speculation from the doctor was that she just acquired the infection from me, or perhaps has a “mild” infection. She was given the 1g Zithromax as treatment.
I am confused because I had tested negative before. I went to the clinic and got tested, and was also given the 1g Zithromax. I am waiting for the results of the test.
I have a few questions.
1. I assume that it is possible that I tested negative in 2004 even though I was positive. However, does it also mean that I have not cleared an asymptomatic infection in about 1.5 years? Just a side note, I had to take amoxicillin for a gum surgery since the 2004 STD test, would this have cleared the chlamydia even if I had it? Or might I have a resistant strain that's asymptomatic and tests negative? I am just thinking that my chance of being the carrier is pretty small. I guess her test could be a false positive, but assuming accuracy this leads to the next question.
2. I read that chlamydia has an incubation period about 10 to 30 days, may be longer. If I am not the carrier and she has not developed antibody to chlamydia, does this mean that she had another partner during the period from March to April, or before? The timing seems important because if her infection by another partner is very recent then the negative results for some other tests (e.g., HIV) are not useful at this point.
3. What is the possibility that her 2005 test was falsely negative and she now tests positive, but because the infection is “mild” (or ending) then there is no response to the antibody test?
4. If my test comes back negative, would this support a false positive test for her?
Thank you for helping me to understand the situation.
In mid 2004 I was tested for STDs and the results were negative for all STDs including chlamydia. Since that time I have not been sexually active until this year.
I started dating a girl at the beginning of March 2006. We both assured each other that we had been tested and are good. Her last test was in late 2005, and she represented that I am the only partner since that time.
In the beginning of April she traveled back to her home in another state. In a routine OBGYN examination a week later the doctor tested for STDs and chlamydia (via swab sample) came up positive. The doctor believes that I am the carrier because he also performed an “antibody”(?) test for chlamydia and she has not yet developed antibodies to the chlamydia infection. The speculation from the doctor was that she just acquired the infection from me, or perhaps has a “mild” infection. She was given the 1g Zithromax as treatment.
I am confused because I had tested negative before. I went to the clinic and got tested, and was also given the 1g Zithromax. I am waiting for the results of the test.
I have a few questions.
1. I assume that it is possible that I tested negative in 2004 even though I was positive. However, does it also mean that I have not cleared an asymptomatic infection in about 1.5 years? Just a side note, I had to take amoxicillin for a gum surgery since the 2004 STD test, would this have cleared the chlamydia even if I had it? Or might I have a resistant strain that's asymptomatic and tests negative? I am just thinking that my chance of being the carrier is pretty small. I guess her test could be a false positive, but assuming accuracy this leads to the next question.
2. I read that chlamydia has an incubation period about 10 to 30 days, may be longer. If I am not the carrier and she has not developed antibody to chlamydia, does this mean that she had another partner during the period from March to April, or before? The timing seems important because if her infection by another partner is very recent then the negative results for some other tests (e.g., HIV) are not useful at this point.
3. What is the possibility that her 2005 test was falsely negative and she now tests positive, but because the infection is “mild” (or ending) then there is no response to the antibody test?
4. If my test comes back negative, would this support a false positive test for her?
Thank you for helping me to understand the situation.
Doctor's Answer
by H. Hunter Handsfield, M.D., Apr 26, 2006 12:00AM
, Apr 26, 2006 12:00AM
To start, serological (antibody) tests for chlamydia have no role in diagnosing active infection. They are not approved or recommended for that purpose; a negative antibody test does not prove someone never was infected, and a positive test doesn't say when the infection occurred. Although sometimes used in the evaluation of female infertility, your partner's negative antibody test says nothing about how long she was infected.
A second important issue concerns what test was used on your partner's cervical swab. If it was a culture test or a nucleic acid amplification test (the 3 trade names are Aptima, Probe-Tec, and Amplicor), the positive result should be considered reliable. If any other test was done, the result might be falsely positive.
To your specific questions:
1) Although it might be possible for men to carry chlamydia for more than a year, it is very rare. To my knowledge, it has never been proven. And yes, amoxicillin, if taken for at least a week, would eradicate chlamydia if it had been present.
2) In the population as a whole, the most common explanation for situations like yours is that one partner or the other has had another partner, who introduced the infection. There are exceptions (false negative tests, false positive tests, prolonged carriage, etc), but they are the exception. But exceptions occur and I cannot make a judgment in your case. If nothing else, however, you need to have a heart-to-heart (and sensitive, non-accusatory) conversation with your partner. Then trust your own judgment, based on what she says and how she says it, not on the lab test results.
3) That is a possible explanation. This also depends a bit on what test she had back in 2005.
4) If your test is negative, there still are other possibilities. Your test is false negative; you never were infected; or she had a false positive result.
I hope this helps. Best wishes-- HHH, MD
A second important issue concerns what test was used on your partner's cervical swab. If it was a culture test or a nucleic acid amplification test (the 3 trade names are Aptima, Probe-Tec, and Amplicor), the positive result should be considered reliable. If any other test was done, the result might be falsely positive.
To your specific questions:
1) Although it might be possible for men to carry chlamydia for more than a year, it is very rare. To my knowledge, it has never been proven. And yes, amoxicillin, if taken for at least a week, would eradicate chlamydia if it had been present.
2) In the population as a whole, the most common explanation for situations like yours is that one partner or the other has had another partner, who introduced the infection. There are exceptions (false negative tests, false positive tests, prolonged carriage, etc), but they are the exception. But exceptions occur and I cannot make a judgment in your case. If nothing else, however, you need to have a heart-to-heart (and sensitive, non-accusatory) conversation with your partner. Then trust your own judgment, based on what she says and how she says it, not on the lab test results.
3) That is a possible explanation. This also depends a bit on what test she had back in 2005.
4) If your test is negative, there still are other possibilities. Your test is false negative; you never were infected; or she had a false positive result.
I hope this helps. Best wishes-- HHH, MD
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I was tested positive for Chlamydia in January of 2OO6. My then boyfriend was tested negative. My gynae prescribed me antiboitics to be taken for one month. I started the course in March and it was finished by April.
My boyfriend and I stay in different states so it wasnt until mid-April that I saw him and we had sexual intercourse again. During this time, I am confident to say that we both did not have any other partners.
However, I've been having inter-menstrual bleeding for almost a month. Although I've had a history of my period lasting as long as two weeks, this is an abnormalty. I searched online and I found out that continuous bleeding is a symptom of chlamydia.
Am I to assume that the antiboitics didn't work? If so, what are the chances of that? My gynae also diagnosed me with Polycystic Ovarian Syndrome. And Ive also read up that this causes abnormal and prolonged bleeding.
Assuming it is chlymadia, the only other way I can assume as to how I MIGHT still have it, is that I slept with my boyfriend after I was tested negative. However we wore a condom and he assured me that it would be safe.
But I'm assuming although he was tested negative, I must have passed it to him during the wait for the results.
So in that case, with my bleeding symptoms -light and heavy- that has been continuous since 14 Mar till today, 6 May, when do you suppose I've recontracted the disease?
It is possible that Im getting symptoms so soon even though I did finish my antibiotics in the month of Mar. It just doesnt make sense to me.
The point is, I was tested positive. I took medication for it for the whole of March. I had sex with my boyfriend around the 3rd week of april. Yet Ive been bleeding since March.
Could it be that I was just having my normal menstruation, and then when I was supposedly infected again in April, it just didnt stop? Does chlymadia symptoms really come so fast?
Thanks for your help doctor.