Evaluation of positive and false‐positive results in syphilis screening of blood donors in Rio de Janeiro, Brazil

Sandes, V. S.; Silva, S. G. C.; I, Motta; Velarde, Luis Guilhermo Coca; Castilho, Selma Rodrigues de

doi:10.1111/tme.12395

Cited by 8 publications

(8 citation statements)

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“…This study is the largest single study of syphilis BFP test results. Like previous studies, we found that 11% of reactive nontreponemal tests were BFPs, and most had low-titers (7,8,15). About 1% of the BFPs were high-and very high-titer BFPs, and 4-fold titer increases in individuals with only BFP syphilis results were not uncommon.…”

Section: Discussionsupporting

confidence: 84%

“…Studies of BFPs have been based on general population syphilis testing, which identified a few hundred BFPs, or testing of specific populations with even fewer BFPs (6,8,9,12,14). These studies found that most BFPs have low titers (Յ1:4), and the nontreponemal tests often revert to nonreactive without intervention (7,15). The largest general population study is from a university hospital, where testing of 300,000 serum samples yielded 726 BFPs with titers of Ն1:4, including 86 BFPs with titers of Ն1:32 (16).…”

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confidence: 99%

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Frequency and Characteristics of Biological False-Positive Test Results for Syphilis Reported in Florida and New York City, USA, 2013 to 2017

et al. 2019

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Discordant syphilis test results, with a reactive nontreponemal test and nonreactive treponemal test are usually considered biological false-positive test results (BFPs), which can be attributed to other conditions. Syphilis surveillance laws mandate laboratory reporting of reactive syphilis tests, which include many BFPs. We describe the frequency of BFPs, titer distributions, and titer increases from reported test results in Florida and New York City (NYC). Reactive nontreponemal tests for individuals with at least one nonreactive treponemal test and no reactive treponemal test were extracted from sexually transmitted disease (STD) surveillance systems in Florida and NYC from 2013 to 2017. Characteristics of individuals with BFPs were analyzed after selecting the observation with the highest titer from each individual. We next considered all results from individuals to characterize persons who had a 4-fold titer increase between successive nontreponemal tests. Among 526,540 reactive nontreponemal tests, there were 57,580 BFPs (11%) from 39,920 individuals. Over 90% (n = 52,330) of BFPs were low titer (≤1:4), but 654 (1%) were high-titer BFPs (≥1:32). Very high-titer (≥1:128) BFPs were more common among individuals over 60 years of age (odds ratio [OR], 2.68; 95% confidence interval [CI], 1.22 to 5.91). A 4-fold increase in titer was observed among 1,863 (14%) individuals with more than one reported BFP. Most BFPs detected by surveillance were low titer, but some were high titer and some had a 4-fold increase in titer. Review of patient histories might identify underlying conditions contributing to these high and rising titers.

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Section: Discussionsupporting

confidence: 84%

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confidence: 99%

Frequency and Characteristics of Biological False-Positive Test Results for Syphilis Reported in Florida and New York City, USA, 2013 to 2017

et al. 2019

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“…En relación a las serologías reactivas para enfermedad de Chagas también la prevalencia encontrada fue similar a otros estudios (4,13,19,20) . Esta enfermedad es endémica en el Paraguay y muchas de las personas son asintomáticas.…”

Section: Resultsunclassified

“…Un estudio realizado en Brasil encontró asociación entre la edad de los donantes, nivel educativo y la serología reactiva para sífilis (13) . En otro estudio realizado en China existe asociación entre el antecedente familiar de infección, compartir algunos objetos personales y tratamiento dental con infección con el VHB (14) .…”

Section: Introductionunclassified

Reactive serologies in donors from the Blood Bank of the Hospital de Clínicas, Paraguay

Amarilla

Montiel

Galeano

2021

Rev. virtual Soc. Parag. Med. Int

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Introducción: las infecciones transmisibles por transfusión constituyen una complicación, ocasionando morbilidad y mortalidad en los receptores de sangre y derivados.Objetivo: determinar la prevalencia de serologías reactivas y la asociación con las características sociodemográficas de los donantes del Banco Sangre del Hospital de Clínicas de San Lorenzo, en el año 2018. Material y método: diseño observacional, descriptivo, retrospectivo, de corte transversal, con muestreo no probabilístico de casos consecutivos. Se incluyó a donantes del Banco de Sangre del Hospital de Clínicas del periodo de enero a diciembre del 2018. Se midieron las variables demográficas (edad y sexo), la presencia o ausencia de serologías reactivas para hepatitis B y C, VIH, enfermedad de Chagas, HTLV I-II y Treponema pallidum.Resultados: la prevalencia global de las serologías reactivas en donantes fue 2,78%. De los 278 donantes incluidos en el estudio, 66,91% fueron masculinos, la media de edad fue 40,89 ± 11 años. Las serologías positivas más frecuentes fueron: hepatitis B 53,96%, enfermedad de Chagas 34,89% y sífilis 20,14%. Existe asociación entre sexo femenino y hepatitis C

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“…In two different studies reported from Brazil (15,16), the reverse algorithm involving the use of the CLIA method improved the results of blood bank serologic screening, but still resulted in a high rate of false positive results in a healthy population, such as blood donors, which continues to be a problem.…”

Section: Resultsmentioning

confidence: 99%

The evaluation of the reverse algorithm for syphilis screening in blood donors

Berkem

Karakoç

2019

Revista Romana De Medicina De Laborator

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Background: In Turkey, prior to transfusion and apheresis, it is mandatory to screen blood for HBsAg, anti-HCV, anti-HIV 1/2, and syphilis. In recent years, efforts have been made to create effective diagnostic algorithms for screening, and as a screening strategy, many countries have switched from traditional algorithms to reverse algorithms. This study was carried out to evaluate the results we obtained after changing to chemiluminescence immunoassay (CLIA) based reverse algorithm, which is more sensitive and specific than the traditional algorithm and VDRL test we currently use for syphilis screening. Methods: The screening algorithm was initiated with the treponemal CLIA method. The reactive samples were tested using a nontreponemal test VDRL and a second treponemal test TPHA. In the descriptive analyses, the averages, numbers, and percentage distributions were calculated. The group comparisons were undertaken with the chi-square test, accepting p < 0.05 as statistically significant. Results: Of the 5,053 samples that were tested with CLIA syphilis TPA assay 5,043 were negative (99.802%) and 10 were positive reactive (0.198%), and the difference between the two was statistically significant (p < 0.001). Ten samples that were recurrently reactive were analyzed by VDRL and TPHA tests simultaneously. VDRL was negative in all 10 samples, whereas TPHA was negative in one sample, but positive in nine samples at a titer of ≥1/160. Conclusion: Based on the results of this study, we decided to use the CLIA method and reverse algorithm instead of using the traditional algorithm and VDRL as the initial screening method.

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Evaluation of positive and false‐positive results in syphilis screening of blood donors in Rio de Janeiro, Brazil

Abstract: CLIA represents an improvement in blood bank serological screening. However, its use in a healthy population appears to result in high rates of false positives. Identifying which characteristics can predict false positives, however, remains a challenge.

Cited by 8 publications

References 19 publications

Frequency and Characteristics of Biological False-Positive Test Results for Syphilis Reported in Florida and New York City, USA, 2013 to 2017

Frequency and Characteristics of Biological False-Positive Test Results for Syphilis Reported in Florida and New York City, USA, 2013 to 2017

Reactive serologies in donors from the Blood Bank of the Hospital de Clínicas, Paraguay

The evaluation of the reverse algorithm for syphilis screening in blood donors

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