Biological false positive serological tests for syphilis among drug addicts.

Kaufman, Richard E.; Weiss, Steven D.; Moore, James D.; Falcone, Virginia H.; Wiesner, Paul J.

doi:10.1136/sti.50.5.350

Cited by 16 publications

(6 citation statements)

References 10 publications

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“…[8] In several earlier surveys (U.S. Department of Health, Education and Welfare, 1972; Wong, 1969; Garner, 1970; Johannsson, 1970; Johannsson and Lassus,1970) of BFP reactions in relatively unselected populations, the prevalence was uniformly less than 1%. [910]…”

Section: Discussionmentioning

confidence: 99%

Evaluation of the usefulness of Treponema pallidum hemagglutination test in the diagnosis of syphilis in weak reactive Venereal Disease Research Laboratory sera

Bala

Toor

Malhotra

et al. 2012

Indian J Sex Transm Dis

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Background and Objectives:Biological false positive (BFP) reactivity by the Venereal Disease Research Laboratory (VDRL) test used for diagnosis of syphilis is a cause for concern. The use of the VDRL as a screening procedure is challenged by some studies. The aim of this study is to determine the prevalence of BFP reactions in different subject groups and to assess the usefulness of Treponema pallidum hemagglutination (TPHA) test in low titre VDRL reactive sera.Materials and Methods:A total of 5785 sera from sexually transmitted diseases (STD) clinic attendees, antenatal clinic attendees, husbands of antenatal cases, peripheral health centres attendees (representing community population) and from patients referred from different OPDs/wards were screened for BFP reactions by the VDRL test. Sera reactive in the VDRL test were confirmed by the TPHA test.Results:Out of 80 qualitative VDRL reactive sera, 68 had <1:8 titre on quantitation and TPHA was positive in 59 samples, indicating BFP reactivity in 0.2% in all the subject groups. BFP was nil in the community population. The male-to-female ratio of BFP reactions was 2:1. VDRL and TPHA positivity was highest (76%) in the age group of 20-29 years. The seroprevalence of syphilis varied from 0.4% to 3.5% in different patient groups.Conclusions:The results of this study highlight that the TPHA positivity was high (86.8%) in sera with VDRL titre less than 1:8. Therefore, for the diagnosis of syphilis, it is recommended that a confirmatory test such as TPHA should be performed on all sera with a reactive VDRL regardless of its titre.

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Section: Discussionmentioning

confidence: 99%

Evaluation of the usefulness of Treponema pallidum hemagglutination test in the diagnosis of syphilis in weak reactive Venereal Disease Research Laboratory sera

Bala

Toor

Malhotra

et al. 2012

Indian J Sex Transm Dis

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“…Spirochete culture in vitro has never been optimized; the in vivo production of T. pallidum antigens is very expensive and requires the use of animals. Furthermore, common antigenic determinants found in pathogenic and nonpathogenic spirochetes permit the detection of cross-reactive antibodies with no clinical significance (8,14,15). To improve the clinical significance of syphilis serology, ELISyph-rG uses selected antigens with respect to their pathogenic determinants (1,11,16).…”

Section: Discussionmentioning

confidence: 99%

“…On the other hand, the close antigenic similarity of T. pallidum to several nonpathogenic bacteria yields to false-positive results (7,11). Both nonspecific binding of antibodies and cross-reactive antibodies generate false-positive results (8,9,14,15).…”

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confidence: 99%

Recombinant antigen-based enzyme immunoassay for screening of Treponema pallidum antibodies in blood bank routine

et al. 1995

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This work reports a comparison of an enzyme immunoassay (EIA) using two major Treponema pallidum recombinant antigens with a T. pallidum hemagglutination (TPHA) assay and a nontreponemal Venereal Disease Reference Laboratory (VDRL) test. A total of 1,822 normal donor serum samples was tested for cardiolipin and T. pallidum antibodies, respectively, by the VDRL assay and EIA. Among these samples, 440 were further tested by TPHA technology. Four samples were found positive by EIA, while all were reported to be negative by both TPHA and VDRL routine assays. Subsequent testing of EIA-positive samples confirmed 100% (four of four samples) and 25% (one of four samples) positive results, respectively, by immunofluorescence assay and a Western blot (immunoblot) syphilis kit. The sensitivity of the recombinant EIA was estimated at virtually 100% with a reference panel of 50 syphilitic samples. According to this study, the newly developed EIA kit shows 100% sensitivity combined to a specificity greater than 99.8% for detecting treponemal immunoglobulin G antibodies in blood bank syphilis screening.

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“…Some reports have shown higher rates (22), but the rate depends on the population studied. If the population includes patients with other treponemal diseases (3), autoimmune disorders such as systemic lupus erythematosus (5,17,25), drug addiction (12,20,25), genital herpes (20,30), or leprosy (20, 25), or if there are elderly (9,20,25) or pregnant (2,18,20,26) patients, the likelihood of a false-positive cardiolipin test result increases. If a screening method with higher specificity were available, false-positive results would be minimized.…”

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confidence: 99%

Evaluation of a Treponema pallidum enzyme immunoassay as a screening test for syphilis

Hooper

Malloy

Passen

1994

Clin Diagn Lab Immunol

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The CAPTIA Syphilis-G enzyme immunoassay for the detection of antibodies to Treponema paUlidum was evaluated as a screening test for syphilis in comparison with the standard rapid plasma reagin (RPR) test. One thousand samples were tested, and the standard fluorescent treponemal antibody absorption test and the standard microhemmaglutination test were used to confirm the presence of treponemal antibodies. Diagnosis of syphilis was based on traditional standard serology results. Clinical data used in the diagnosis of patients whose samples yielded conflicting results were provided by physicians. Initially, 7 patients whose samples were reactive in the RPR test and 14 patients whose samples yielded positive or equivocal results in the CAPTIA Syphilis-G test were diagnosed as not being infected. After discrepancies due to technical problems were reconciled, samples from six patients remained reactive in the RPR test and that from one patient remained positive in the CAPTIA Syphilis-G test. In addition, seven patients whose samples were nonreactive in the RPR test and two patients whose samples were negative in the CAPITIA Syphilis-G test were diagnosed as having untreated syphilis. After discrepancies were reconciled, samples from five patients remained nonreactive in the RPR test and none remained negative in the CAPIFA Syphilis-G test. Final results indicate that the sensitivities of the RPR test and the CAPTIA Syphilis-G test are 86.1 and 100%o, respectively, and that the specificities are 99.4 and 99.9%o, respectively. In addition to the improved sensitivity and specificity of the CAPTIA Syphilis-G screen, other potential benefits of this assay lead us to believe that this method could serve as a better screening tool than the RPR test.

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Biological false positive serological tests for syphilis among drug addicts.

Cited by 16 publications

References 10 publications

Evaluation of the usefulness of Treponema pallidum hemagglutination test in the diagnosis of syphilis in weak reactive Venereal Disease Research Laboratory sera

Evaluation of the usefulness of Treponema pallidum hemagglutination test in the diagnosis of syphilis in weak reactive Venereal Disease Research Laboratory sera

Recombinant antigen-based enzyme immunoassay for screening of Treponema pallidum antibodies in blood bank routine

Evaluation of a Treponema pallidum enzyme immunoassay as a screening test for syphilis

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