Antibodies to Chlamydia trachomatis and reproductive health issues in women with SLE: a case-control study

SLE is an autoimmune condition affecting predominantly women. Little is known regarding Chlamydia trachomatis infection in women with SLE, which may drive autoimmunity and contribute to obstetrical and vascular complications.

This single-centre, case-control study set primary endpoint in the comparative seropositivity rate to C. trachomatis major outer membrane protein (MOMP) and chlamydial heat-shock protein-60 (cHSP60) in age-matched subjects. The secondary endpoints were obstetrical outcomes, cardiovascular events and results from screening procedures for cervical cancer.

Eighty-four women with SLE and 50 age-matched controls were included. Seropositivity to C. trachomatis did not differ significantly between groups (10% of cases positive for anti-MOMP vs 12% of controls; 43% of cases positive for anti-cHSP60 vs 32% of controls). Women with SLE were more often of non-Caucasian ethnicity and had lower educational level. They relied less frequently on oral contraception and resorted more frequently to elective pregnancy termination. Pre-eclampsia and ectopic pregnancy occurred only in SLE. Women with SLE also experienced more cardiovascular events. In SLE, antibodies to cHSP60 were associated with a history of pericarditis and abnormal screening tests for cervical cancer. Antibody titres to C. trachomatis were not associated with disease activity or SLE treatment, nor were there associations with other gynaecological, obstetrical or vascular outcomes.

Prevalence of antibodies to C. trachomatis was not increased in women with SLE. No significant association was found between these antibodies and obstetrical or cardiovascular complications.