An Evaluation of the Relative Sensitivities of the Venereal Disease Research Laboratory Test and the Treponema pallidum Particle Agglutination Test Among Patients Diagnosed With Primary Syphilis

Creegan, Linda; Bauer, Heidi M.; Samuel, Michael C.; Klausner, Jeffrey D.; Liska, Sally; Bolan, Gail

doi:10.1097/olq.0b013e3181124473

Cited by 56 publications

(37 citation statements)

References 8 publications

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“…In 37 of these patients, the initially positive treponemal IgM declined after therapy, proving that the VDRL result was false-negative. Thus, VDRL test sensitivity was only 58% for primary syphilis, which is lower than previously reported sensitivities of between 66% and 87% [9–11]. Despite this, the VDRL test has been used for first-line screening in the United States [9], and is recommended in textbooks [12].…”

Section: Discussionmentioning

confidence: 95%

Serological Response to Treatment of Syphilis According to Disease Stage and HIV Status

Knaute¹,

Graf²,

Lautenschlager

et al. 2012

Clinical Infectious Diseases

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Section: Discussionmentioning

confidence: 95%

Serological Response to Treatment of Syphilis According to Disease Stage and HIV Status

Knaute¹,

Graf²,

Lautenschlager

et al. 2012

Clinical Infectious Diseases

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“…Serologic testing has reduced sensitivity in very early disease and may fail to capture subjects with early treated disease 36 . Further, incident syphilis is best characterized by measuring rates of early stage disease (i.e.…”

Section: Discussionmentioning

confidence: 99%

Results of a 25-Year Longitudinal Analysis of the Serologic Incidence of Syphilis in a Cohort of HIV-Infected Patients With Unrestricted Access to Care

Ganesan

Fieberg

Agan

et al. 2012

Sexually Transmitted Diseases

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Background The well described biological and epidemiologic associations of syphilis and HIV are particularly relevant to the military, as service members are young and at risk for sexually transmitted infections. We therefore used the results of serial serologic testing to determine the prevalence, incidence, and risk factors for incident syphilis in a cohort of HIV-infected Department of Defense beneficiaries. Methods Participants with a positive non-treponemal test at HIV diagnosis that was confirmed on treponemal testing were categorized as prevalent cases, whereas participants with an initial negative non-treponemal test who subsequently developed a confirmed positive non-treponemal test as incident cases. Results At HIV diagnosis the prevalence of syphilis was 5.8% (n=202). 4239 participants contributed 27,192 person years (PY) to the incidence analysis and 347 (8%) developed syphilis (rate 1.3/100 PY; [1.1, 1.4]). Syphilis incidence was highest during the calendar years 2006 - 2009 (2.5/100 PY; [2.0, 2.9]). In multivariate analyses, younger age (per 10 year increase HR 0.8;[0.8-0.9]); male gender (HR 5.6; [2.3-13.7]); non European-American ethnicity (African-American (HR 3.2; [2.5-4.2]; Hispanic HR 1.9; [1.2-3.0]); history of hepatitis B (HR 1.5; [1.2-1.9]) or gonorrhea (HR 1.4; [1.1 −1.8]) were associated with syphilis. Conclusions The significant burden of disease both at and after HIV diagnosis, observed in this cohort, suggests that the cost-effectiveness of extending syphilis screening to at risk military members should be assessed. In addition, HIV infected persons continue to acquire syphilis, emphasizing the continued importance of prevention for positive programs.

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“…However, because they do not become positive until 10–15 days after onset of the primary lesion, 25–30% of primary syphilis cases may be missed (Fig. 6) 132,133 . Although relatively simple and inexpensive, NTTs must be performed manually on serum, and rely on subjective interpretation (Table 2).…”

Section: Diagnosis Screening and Preventionmentioning

confidence: 99%

“…Not recommended for resolution of discordant TT/NTT results due to potentially lower sensitivity and specificity than other TTs 132,204 …”

Section: Figurementioning

confidence: 99%

Syphilis

Peeling

Mabey

Kamb

et al. 2017

Nat Rev Dis Primers

519

387

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Treponema pallidum subspecies pallidum (T. pallidum) causes syphilis via sexual exposure or vertical transmission during pregnancy. T. pallidum is renowned for its invasiveness and immune-evasiveness; its clinical manifestations result from local inflammatory responses to replicating spirochetes and often imitate those of other diseases. The spirochete has a long latent period during which patients have no signs or symptoms, but can remain infectious. Despite the availability of simple diagnostic tests and the effectiveness of treatment with a single dose of long-acting penicillin, syphilis is re-emerging as a global public health problem, particularly among men who have sex with men (MSM) in high-income and middle-income countries. Syphilis also causes several hundred thousand stillbirths and neonatal deaths every year in developing nations. Although several low-income countries have achieved WHO targets for the elimination of congenital syphilis, an alarming increase of syphilis in HIV-infected MSM serves as a strong reminder of the tenacity of T. pallidum as a pathogen. Strong advocacy and community involvement is needed to ensure that syphilis is given high priority on the global health agenda. More investment in research is needed on the interaction between HIV and syphilis in MSM, as well as into improved diagnostics, a better test of cure, intensified public health measures and, ultimately, a vaccine.

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An Evaluation of the Relative Sensitivities of the Venereal Disease Research Laboratory Test and the Treponema pallidum Particle Agglutination Test Among Patients Diagnosed With Primary Syphilis

Cited by 56 publications

References 8 publications

Serological Response to Treatment of Syphilis According to Disease Stage and HIV Status

Serological Response to Treatment of Syphilis According to Disease Stage and HIV Status

Results of a 25-Year Longitudinal Analysis of the Serologic Incidence of Syphilis in a Cohort of HIV-Infected Patients With Unrestricted Access to Care

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