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Is a blood report of VDRL reactive suggestive of syphilis?

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Posted on Wed, 7 Oct 2015
Question: Hi Doctor,

Recently during a blood donation activity, I got to know that I was VDRL reactive (VDRL RPR test). I repeated the test from an external laboratory and the findings were consitent ie VDRL reactive(titers were not provided). I got a TPHA test done and it returned as negative. Does this mean I do not have Syphilisis or do I need to get any other tests done? Or shall I start treatment of syphilisis based on VDRL results?
For reference: I am sexually inactive, the last sexual encounter was around 2.5 yrs back using protection with a stranger, otherwise never had sex with anyone.
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Answered by Dr. Prasanna Heijebu (4 hours later)
Brief Answer:
Require FTA-ABS test for confirmation.

Detailed Answer:
Hello, Sir.

I understand your concern.

Syphilis is caused by a treponeme bacteria.

VDRL is a non-treponemal test using for screening purposes which detect antibodies against treponeme in our blood.

In the absence of symptoms or recent sexual encounter, a REACTIVE VDRL can either be a false positive or a reflection of infection in the remote past or a latent stage of syphilis.

Because of the possibility of false-positive results, confirmation for any positive or equivocal nontreponemal test result should follow with a treponemal test, such as the fluorescent treponemal antibody-absorption (FTA-ABS).

FTA-ABS is commonly used as a confirmatory test following positive VDRL.
FTA-ABS has almost 100% sensitivity for detecting syphilis infection in other stages. Its specificity is 96%.

Hence, I advise you to get FTA-ABS instead of TPHA.

You need treatment only of FTA-ABS is positive.

Post your further queries if any.

Thank you.





Above answer was peer-reviewed by : Dr. Yogesh D
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Answered by
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Dr. Prasanna Heijebu

General & Family Physician

Practicing since :2010

Answered : 1422 Questions

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Is a blood report of VDRL reactive suggestive of syphilis?

Brief Answer: Require FTA-ABS test for confirmation. Detailed Answer: Hello, Sir. I understand your concern. Syphilis is caused by a treponeme bacteria. VDRL is a non-treponemal test using for screening purposes which detect antibodies against treponeme in our blood. In the absence of symptoms or recent sexual encounter, a REACTIVE VDRL can either be a false positive or a reflection of infection in the remote past or a latent stage of syphilis. Because of the possibility of false-positive results, confirmation for any positive or equivocal nontreponemal test result should follow with a treponemal test, such as the fluorescent treponemal antibody-absorption (FTA-ABS). FTA-ABS is commonly used as a confirmatory test following positive VDRL. FTA-ABS has almost 100% sensitivity for detecting syphilis infection in other stages. Its specificity is 96%. Hence, I advise you to get FTA-ABS instead of TPHA. You need treatment only of FTA-ABS is positive. Post your further queries if any. Thank you.