{
  "abstract": "Background Adolescent girls and young women (AGYW) in sub-Saharan Africa are disproportionately affected by Chlamydia trachomatis (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.Methods An observational cohort of 298 sexually active AGYW (aged 16–22 years) from Cape Town and Johannesburg was enrolled. Participants in Johannesburg attended one visit, while those in Cape Town were followed longitudinally (6–8 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 ompA genotyping examined strain diversity.Results CT prevalence was 2.4-times higher in Cape Town (41.6%) than Johannesburg (17.4%). CT infection was associated with upregulated interleukin (IL)-1β, IL-6 and tumour necrosis factor (TNF)-α, 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)-γ concentrations, whereas genovar E, more common in Johannesburg, was associated with higher IFN-γ 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.Conclusions CT-associated immune responses in AGYW appear to reflect a combination of pathogen diversity, regional context and host immune history.",
  "authors": [
    {
      "affiliations": [
        "Division of Medical Virology, Department of Pathology, University of Cape Town, Observatory, South Africa",
        "The University of British Columbia Faculty of Medicine, Vancouver, British Columbia, Canada"
      ],
      "name": "Smritee Dabee"
    },
    {
      "affiliations": [
        "Division of Medical Virology, Department of Pathology, University of Cape Town, Observatory, South Africa",
        "Department of Medicine, Desmond Tutu HIV Centre, University of Cape Town, Cape Town, South Africa"
      ],
      "name": "Shaun Barnabas"
    },
    {
      "affiliations": [
        "Division of Medical Virology, Department of Pathology, University of Cape Town, Observatory, South Africa",
        "DST-NRF CAPRISA Centre of Excellence in HIV Prevention, University of Cape Town, Rondebosch, South Africa"
      ],
      "name": "Brian Kullin"
    },
    {
      "affiliations": [
        "Knowledge Institute of the Dutch Association of Medical Specialists, Utrecht, The Netherlands"
      ],
      "name": "Bart Versteeg"
    },
    {
      "affiliations": [
        "National Institute for Communicable Diseases, Centre for HIV and STIs, National Health Laboratory Service, Johannesburg, South Africa"
      ],
      "name": "Nonhlanhla Mkhize"
    },
    {
      "affiliations": [
        "National Institute for Communicable Diseases, Centre for HIV and STIs, National Health Laboratory Service, Johannesburg, South Africa"
      ],
      "name": "Etienne Muller"
    },
    {
      "affiliations": [
        "National Institute for Communicable Diseases, Centre for HIV and STIs, National Health Laboratory Service, Johannesburg, South Africa"
      ],
      "name": "Venessa Maseko"
    },
    {
      "affiliations": [
        "Western Sydney Sexual Health Centre, Western Sydney Local Health District, Wentworthville, New South Wales, Australia",
        "Sydney Infectious Diseases Institute & Sydney Medical School Westmead, The University of Sydney, Sydney, New South Wales, Australia"
      ],
      "name": "David A Lewis"
    },
    {
      "affiliations": [
        "Perinatal HIV Research Unit, University of the Witwatersrand Johannesburg Faculty of Health Sciences, Johannesburg, South Africa"
      ],
      "name": "Janan Dietrich"
    },
    {
      "affiliations": [
        "Perinatal HIV Research Unit, University of the Witwatersrand Johannesburg Faculty of Health Sciences, Johannesburg, South Africa",
        "South African Medical Research Council, Tygerberg, South Africa"
      ],
      "name": "Glenda Gray"
    },
    {
      "affiliations": [
        "Department of Medicine, Desmond Tutu HIV Centre, University of Cape Town, Cape Town, South Africa",
        "University of Cape Town Institute of Infectious Disease and Molecular Medicine, Rondebosch, South Africa"
      ],
      "name": "Katherine Gill"
    },
    {
      "affiliations": [
        "Department of Medicine, Desmond Tutu HIV Centre, University of Cape Town, Cape Town, South Africa",
        "University of Cape Town Institute of Infectious Disease and Molecular Medicine, Rondebosch, South Africa"
      ],
      "name": "Linda-Gail Bekker"
    },
    {
      "affiliations": [
        "University of Cape Town Institute of Infectious Disease and Molecular Medicine, Rondebosch, South Africa",
        "Computational Biology Unit, Department of Integrative Biomedical Sciences, University of Cape Town, Observatory, South Africa"
      ],
      "name": "Musalula Sinkala"
    },
    {
      "affiliations": [
        "University of Cape Town Institute of Infectious Disease and Molecular Medicine, Rondebosch, South Africa",
        "Computational Biology Unit, Department of Integrative Biomedical Sciences, University of Cape Town, Observatory, South Africa"
      ],
      "name": "Darren P Martin"
    },
    {
      "affiliations": [
        "Department of Infectious Diseases, Public Health Service of Amsterdam, Amsterdam, The Netherlands",
        "Academic Medical Center, Amsterdam Infection and Immunity Institute, University of Amsterdam, Amsterdam, The Netherlands"
      ],
      "name": "Sylvia M Bruisten"
    },
    {
      "affiliations": [
        "University of Cape Town Institute of Infectious Disease and Molecular Medicine, Rondebosch, South Africa",
        "Seattle Children’s Research Institute, Seattle, Washington, USA"
      ],
      "name": "Heather B Jaspan"
    },
    {
      "affiliations": [
        "Division of Medical Virology, Department of Pathology, University of Cape Town, Observatory, South Africa",
        "DST-NRF CAPRISA Centre of Excellence in HIV Prevention, University of Cape Town, Rondebosch, South Africa",
        "Centre for Epidemic Response and Innovation (CERI), School of Data Science and Computational Thinking, Stellenbosch University, Stellenbosch, South Africa",
        "Division of Medical Virology, Department of Pathology, Stellenbosch University, Tygerberg, Cape Town, South Africa"
      ],
      "name": "Jo-Ann S Passmore"
    }
  ],
  "title": "Cervicovaginal inflammation and HIV target cell activation in adolescent girls and young women with Chlamydia trachomatis infections",
  "uid": "10f28d20-1eee-58ec-b5b4-6ce130d5320a"
}