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What Is The Window Period To Test Syphilis?

Posted on Thu, 4 Sep 2014

Question: I performed oral sex on a man from XXXXXXX 7 weeks ago. 4 weeks later, I had a full panel std test done including HIV antibody, Syphilis RPR and a Hep B test. I'm not overly worried about the Hep B or the HIV. Hep B I have heard is only a theoretical risk and HIV depending on who you ask was a 1 in 20,000 risk of contracting through oral sex, but also because 90% of people using an ELISA 3rd generation would have shown positive by 29 days. What I can't seem to find is how much I can trust my syphilis test at 29 days. I have read that 6 weeks is conclusive, but 4 weeks is a good indicator. I have no symptoms of syphilis that I can tell at least, but I have read that you can have it and not know it which is insanely scary. So, my question is how accurate is a Syphilis RPR at 4 weeks? Can I trust my negative and move on, or should I have another test performed now at 7 weeks post exposure?

Answered by Dr. Dr. Muhammad Sareer Khalil (3 hours later)

Brief Answer:
explained

Detailed Answer:
Syphilis is an infectious venereal disease caused by the spirochete Treponema pallidum. Syphilis is transmissible by sexual contact with infectious lesions, from mother to fetus in utero, via blood product transfusion, and occasionally through breaks in the skin that come into contact with infectious lesions. If untreated, it progresses through 4 stages: primary, secondary, latent, and tertiary.

Syphilis has a myriad of presentations and can mimic many other infections and immune-mediated processes in advanced stages. Hence, it has earned the nickname “the great impostor

Serologic testing is considered the standard method of detection for all stages of syphilis.

Recommended testing for syphilis begins with screening tests (VDRL or RPR) followed by confirmatory diagnostic testing (FT-ABS or TPPA).

so you can go for FT ABS or TPPA if you are too much worried about syphilis.

let me know if you have any query
thanks

Above answer was peer-reviewed by : Dr. Vinay Bhardwaj

Follow up: Dr. Dr. Muhammad Sareer Khalil (7 minutes later)

That didn't answer my question at all. I'm aware which test are available, but thank you for the information. My question was regarding how accurate an RPR is 4 weeks post a possible exposure and whether or not my negative at 4 weeks should be considered conclusive? I appreciate the wikipedia style info dump, but I can get that from Google. Would you mind answering the actual question now?

Answered by Dr. Dr. Muhammad Sareer Khalil (16 minutes later)

Brief Answer:
explained

Detailed Answer:
hello again,

I am sorry for your distress.

let me try again.

RPR is not a very sensitive test i.e 75 to 85 % sensitivity for primary syphilis , it can give false positives at both 4 , 6 or 8 weeks post duration.

so your test cant be considered conclusive unless you get an FT ABS or TPPA.

hope this clears things up
thanks

Note: Consult a Sexual Diseases Specialist online for further follow up- Click here.

Above answer was peer-reviewed by : Dr. Vinay Bhardwaj