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Worried about contracting syphilis. History of RPR during pregnancy. Could I still have it?

Mar 2013
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Practicing since : 1998
Answered : 5609 Questions

I have always been concerned about STDs. Every once in a while my concern comes back even though I have been married and in a monogamous relationship for many years. I have a fear of syphillis. I have never had symptoms but I am worried about it from many years ago in high school, about 18 years now. I was tested with the RPR in my first pregnancy and that was 9 years ago and then 2 years ago with my second pregnancy and both were nonreactive. Could I still have this? I am obsessing that I will get nuerosyphillis. i am worried about accuracy or would that have been picked up in one of those tests? Do you know the accuracy percentages?
Posted Sat, 6 Apr 2013 in Sexually Transmitted Diseases
Answered by Dr. Aarti Abraham 42 minutes later
Thanks for your query.
Am glad you used the word obsessed because in the absence of any symptoms, and being in a monogamous relationship for years, you are definitely harbouring an unnatural fear of syphilis.
That said and done, maybe it's better for you to test and be done with it, to cure your obsession.
Firstly, tests for syphilis are based on detecting antibodies against the causal organism, Treponema Pallidum in the blood, body fluids or tissues.
Tests can be either screening tests or confirmatory tests.
Screening tests include the VDRL test, RPR test or EIA test.

The VDRL test checks antibodies produced against the syphilis organism, however the test is not specific for syphilis. It is not useful in early or very late stages .
Similarly the RPR test is also not specific for syphilis.
EIA test Is a newer screening test.

However, all screening tests are sensitive , but not specific. This means that if syphilis is present they are good at detecting it, but if the test is positive, one cannot always be sure it is syphilis that is causing positivity.

Always a screening test is recommended first for suspected individuals.
However, given your apprehension, as a rarity, you can directly go for one of the confirmatory tests below :

FTA ABS test - Flourescent treponemal antibody absorption test. It specifically tests for the direct antibody.
TPPA test.
TP MHA - Treponema Pallidum Micro HemAgglutination test.

These tests are normally done to confirm a positive screening test, however in your case you can unconventionally request these to allay your anxiety, as these are quite accurate for syphilis.

Hope this helped you.
Take care.
Feel free to discuss further.

Above answer was peer-reviewed by
Follow-up: Worried about contracting syphilis. History of RPR during pregnancy. Could I still have it? 10 minutes later
Thank you for your answer. Do you think that even though I took the RPR test years later that there was any accuracy to these tests being non reactive? I always questioned something on my husband years back, as we have been together since then but he is adamant that it was not such. I am now terrified that I could have passed syphills on to my children. Would I know that!?

Again, do you think the tests I took mean anything at all? I am panicking.
Answered by Dr. Aarti Abraham 9 minutes later
As I said, the RPR test is not confirmatory.
You could have yourself and your husband both tested by confirmatory tests.
That's the only way to know for sure.
Given that you are both healthy years later, possibility of syphilis seems remote.
Take care.
Above answer was peer-reviewed by
Follow-up: Worried about contracting syphilis. History of RPR during pregnancy. Could I still have it? 2 minutes later
Last question: I know it's a screening but do you think something would have popped up on the two tests that I took? I'm assuming they are
Rpr as I believe they use this for prenatal screening?
Answered by Dr. Aarti Abraham 1 minute later
As is said they are screening tests, but highly sensitive,
If you had something, chances are high it would have come up on RPR.
Above answer was peer-reviewed by
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