Chlamydia – Induced Reactive Arthritis
There is a form of arthritis called reactive arthritis, which is a kind of inflammatory arthritis that usually occurs in reaction to an infection cause by certain bacteria.
It can affect your heels, toes, fingers, low back, and joints. The infection that is manifested in your body shows up as diarrhea or a sexually transmitted disease (STD).
Chlamydia Trachomatis is a common post-venereal form of reactive arthritis that often occurs in the genitals or the bowel, and is known as Chlamydia-induced reactive arthritis. The reactive arthritis id not manifested right away and can take up to three weeks after the affected area was exposed to an infection.
However, it is believed that reactive arthritis can also be genetic and is not always caused by infections. This conclusion was reached by observing that cases of reactive arthritis were frequent among individuals who carried certain genetic markers. The Human Leukocyte Antigen (HLA) B27 gene is common with those diagnosed with reactive arthritis.
According to the Spondylitis Association of America, only 8% of the general population carries the HLA-B27 gene. It is worth noting, though, that even those with a genetic background of reactive arthritis often develop the disease after being exposed to certain infections. Genital infection of chlamydia trachomatis is often associated with urethritis or cervicitis and can by asymptomatic, meaning those infected will not display any signs or symptoms of infection.
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Another type of infection is chlamydia pneumonia, which can cause respiratory tract illness. Both infections can cause infected individuals to developing swelling and stiffness of the knee or other joints.
Although reactive arthritic is not contagious, certain infections that can reactive arthritis are. It is possible to contract sexually transmitted diseases and infections when you engage in sexual intercourse with an individual who carries the infection.
In many cases, patients’ reactive arthritis is inflamed by a bladder or vaginal infection that was transmitted through sexual contact. It is still inconclusive as to how or why exactly reactive arthritis stems from these infections or bacteria.
The Center for Disease and Control (CDC) reports over 100 million new cases of infections by Chlamydia trachomatis worldwide each year.4% to 8% develop Chlamydia-induced reactive arthritis up to 6 weeks after getting infected.
70% displayed symptoms of chlamydia-induced reactive arthritis for a few weeks, but others relapsed into chlamydia-induced reactive arthritis for many years after the infection.
The majority of those who suffer from chlamydia-induced reactive arthritis are men, and data shows that it is 9 times for likely for men rather than women to contract chlamydia-induced reactive arthritis as a result of sexually acquired infections.
Is There A Cure?
A trial sponsored by the National Institute of Arthritis and Musculoskeletal and Skin Diseases (NIAMS) aimed to investigate whether a certain combination of antibiotics would be an effective treatment for chlamydia-induced reactive arthritis.
A team in the University of South Florida College of Medicine conducted the study and their findings were reported in the May 2010 issue of Arthritis and Rheumatism. They deduced that chlamydia-induced reactive arthritis existed in a state of infection and would be weakened by antimicrobial agents.
The study went on for a period of 9 months and was very extensive. During the 9-months, the researcher assessed a 6-month course of medication of a combination of antibiotics as a treatment for chlamydia-induced reactive arthritis. The study was a randomized placebo-controlled evaluation of the effects of the antibiotic combination on 42 test subjects.
All those who joined the study were positive for chlamydia trachomatis or chlamydia pneumonia and had reactive arthritis.
Each individual was randomly assigned to a certain group and each group received a different combination of antibiotics. One group of people received doxycycline and rifampin plus placebo instead of azithromycin.
Another group received azithromycin andrifampin plus placebo instead of doxycycline. The third group received placebos instead of azithromycin, doxycycline, and rifampin. Rifampin was included in the antibiotic combination because of its ability to penetrate tissue, which is mandatory in the treatment of pathogens that are intracellular such as chlamydia.
The other drug was either doxycycline or azithromycin, but never all three together. The last group received none of the drugs, only placebos.
The primary goal was achieved in 17 out of 27 patients, representing 63%, receiving antibiotics and in 3 out of 15 patients, representing 20% receiving the placebo. After 6 months, 6 out of 27 receiving the antibiotics believed that their disease went into complete remission.
Patients in this group were tested and were found to be negative for chlamydia trachomatis and chlamydia pneumonia. 0% of those receiving the placebo claimed to have gone into remission. Some patients experienced gastrointestinal side effects, but all the side effects experienced were very mild.
The researchers concluded that their experiment was successful and that the data they gathered and analyzed suggested that a 6-month course of combination antibiotics could be used to successfully treat chlamydia-induced reactive arthritis.
In the Arthritis & Rheumatism publication they said that their findings warranted further studies and that it had great potential to work towards the eradication of chlamydia trachomatis, chlamydia pneumonia, and chlamydia-induced reactive arthritis. They claimed that they had not yet found the optimal dosage and duration of the antibiotics.
Their study has created a lot of buzz in the arthritis community and is the precedent for all future similar studies. Other researchers will be able to use their findings as a jumping off point and can improve upon it. There are many other branches of medicine that will be able to benefit from the study.
Dr. Markus Rihl of Hanover Medical School said “the positive results using combination antibiotics are very promising to open a new way of treatment not only for Chlamydia-induced reactive arthritis but also for Chlamydia-induced spondylarthritis.”
The Louisiana State Health Science Center, Wayne State University School of Medicine, and the University of Toronto all participated in the trial as well.