Serological screening for syphilis in HIV-infected individuals: is a non-treponemal test adequate in the era of increasing of new syphilis infections?

Size: px
Start display at page:

Download "Serological screening for syphilis in HIV-infected individuals: is a non-treponemal test adequate in the era of increasing of new syphilis infections?"

Transcription

1 Abstract no. WEPE 494 Serological screening for syphilis in HIV-infected individuals: is a non-treponemal test adequate in the era of increasing of new syphilis infections? G.Chrysos 1, D.Karageorgopoulos 1,3, A.Lazaridou 2, C.Poulopoulou 2, K.Chrysou 1, P.Chatziastros 1, E.Friligou 1, P. Mistylis 1, A.Sotiropoulos 1, K.Digalaki 2, D.Paraskeva 1,3 1. Infectious Diseases Unit; 2. Department of Microbiology, Tzaneio General Hospital, Piraeus, 3. Hellenic Center for Disease Control and Prevention, Athens, Greece

2 Background Traditionally, serologic screening for syphilis involves performing a nontreponemal test (e.g. VDRL, RPR) first, which is confirmed, if positive, with a treponemal test. The diagnostic accuracy of non-treponemal tests for syphilis might be lower in patients with HIV-infection. False positive tests due to immune activation can be common. False negative tests can also be observed, particularly in seriously immunocompromised patients. The reversal of the traditional order of serologic testing for syphilis (i.e., performing a treponemal test first) is gaining interest with regard to HIV-infected patients. The advent of automated enzyme immunoassay tests facilitates the change in the screening algorithm. We aimed to assess serologic screening for syphilis with the use of the Fluorescent Treponemal Antibody Absorption test (FTA-Abs) in HIV-positive patients.

3 Patients and methods Because of a steep increase in the incidence of syphilis in high-risk patient groups in Greece, FTA-Abs testing has been included, along with Rapid Plasma Reagin (RPR) testing, in the routine (every 6-12 months) serologic screening protocol for syphilis, followed at the HIV Clinic (Infections Diseases Unit) of Tzaneio General Hospital, Piraeus, Greece, in January We retrospectively examined the records of the Microbiology Laboratory of our hospital to identify the patients followed in the HIV Clinic who had undergone serologic testing for syphilis between 1/1/2010 and 1/10/2011. We reviewed all of the available paper and electronic medical records of these patients and extracted relevant demographic, clinical and laboratory data.

4 Results (1) During the study period, 171 unique HIV-infected, sexually-active patients were screened at least once with FTA-Abs for syphilis, out of the 350 patients followed in our Clinic. 135/171 (78,9%) had a negative FTA-Abs test result. None of the above 135 patients had a positive non-treponemal RPR test.

5 Results (2) 23/171 (13,5%) had a positive FTA-Abs test result. Out of the 23 patients with positive FTA-Abs, 9 (39,1%) also had a positive RPR test. Five out of the 9 patients with both tests positive, were found to have early syphilis. The remaining 14/23 (60,9%) FTA-Abs positive patients had negative RPR. 3/14 patients underwent additional serologic testing at a reference laboratory and did not have a positive result for another treponemal test (Treponema pallidum particle agglutination assay (TP-PA) or Treponema pallidum enzyme immunoassay (TP-EIA)). Thus, the positive FTA-Abs test result was considered as false-positive. 4/14 patients had a positive clinical history for syphilis or a history of previously positive serologic tests for syphilis.

6 Results (3) 13/171 (7,6%) additional patients had an indeterminate or weekly positive FTA-Abs test result Out of the 13 patients with indeterminate/weekly positive FTA-Abs, 1 (7,7%) patient had positive RPR and early syphilis, 6 (50,0%) had negative RPR, For the remaining 6 patients, data for a recent RPR test were not available.

7 Results (4) FTA + FTA - FTA ± TOTAL RPR (5.8%) RPR (94.2) TOTAL 23 (13.5%) 135 (78.9%) 13 (7.6%) 171 (100%)

8 Main findings and discussion The use of FTA-Abs in the serologic screening for syphilis in HIV-infected patients resulted in the identification of all of the 10 patients who had a positive RPR. 20/171 (11,7%) patients had a positive or indeterminate FTA-Abs test with a negative RPR. These patients could have had false positive FTA-Abs, treated syphilis, or late latent syphilis (false negative RPR). Although the sensitivity of RPR in diagnosing syphilis is considered very high, case reports have described RPR-seronegative syphilis in HIV-positive patients. A negative non-treponemal test may not rule out syphilis in patients with advanced immunosuppression. Reinfection may be difficult to rule out in some patients, and reactivation or relapse of a previously treated infection is also possible for an HIV-positive person. The diagnostic value of FTA-ABS can be greater in HIV-infected patients with latent syphilis. FTA-ABS turns positive earlier and remains positive longer than RPR.

9 Conclusion The use of FTA-Abs in the serologic screening for syphilis in HIV-infected patients can lead to the identification of a greater number of patients with probable syphilis than with RPR alone. Clinicians should consider the sensitivity of FTA-ABS to be high in HIV-infected persons with untreated syphilis beyond the primary stage of infection. The patients with a positive FTA-Abs test and a negative RPR test need confirmatory testing with another treponemal test. If asymptomatic patients have a positive non-treponemal test and negative confirmatory treponemal test results, it is very unlikely that they have active syphilis.

10 Literature cited 1. Centers for Disease Control and Prevention (CDC). Syphilis testing algorithms using treponemal tests for initial screening-- four laboratories, New York City, MMWR Morb. Mortal. Wkly. Rep. 2008; 57: Workowski KA, Berman S. Sexually transmitted diseases treatment guidelines, MMWR Recomm Rep 2010; 59:1-110.

Direct Comparison of the Traditional and Reverse Syphilis Screening Algorithms

Direct Comparison of the Traditional and Reverse Syphilis Screening Algorithms JCM Accepts, published online ahead of print on 16 November 2011 J. Clin. Microbiol. doi:10.1128/jcm.05636-11 Copyright 2011, American Society for Microbiology and/or the Listed Authors/Institutions. All

More information

Use of Treponemal Immunoassays for Screening and Diagnosis of Syphilis

Use of Treponemal Immunoassays for Screening and Diagnosis of Syphilis Use of Treponemal Immunoassays for Screening and Diagnosis of Syphilis Guidance for Medical Providers and Laboratories in California These guidelines were developed by the California Department of Public

More information

Replaces: 04/13/17. / Formulated: 7/05 SYPHLIS

Replaces: 04/13/17. / Formulated: 7/05 SYPHLIS Effective Date: 81017 Replaces: 041317 Page 1 of 7 POLICY: The Texas Department of Criminal Justice (TDCJ) will identify, test, and manage all offenders with suspected or confirmed syphilis with a uniform

More information

CAP Laboratory Improvement Programs. Prevalence of Traditional and Reverse-Algorithm Syphilis Screening in Laboratory Practice

CAP Laboratory Improvement Programs. Prevalence of Traditional and Reverse-Algorithm Syphilis Screening in Laboratory Practice CAP Laboratory Improvement Programs Prevalence of Traditional and Reverse-Algorithm Syphilis Screening in Laboratory Practice A Survey of Participants in the College of American Pathologists Syphilis Serology

More information

Int.J.Curr.Microbiol.App.Sci (2018) 7(8):

Int.J.Curr.Microbiol.App.Sci (2018) 7(8): International Journal of Current Microbiology and Applied Sciences ISSN: 2319-7706 Volume 7 Number 08 (2018) Journal homepage: http://www.ijcmas.com Original Research Article https://doi.org/10.20546/ijcmas.2018.708.085

More information

10/19/2012. Serologic Testing for Syphilis. Disclosures. Comparison of the Traditional and Reverse Screening Algorithms. Outline.

10/19/2012. Serologic Testing for Syphilis. Disclosures. Comparison of the Traditional and Reverse Screening Algorithms. Outline. Serologic Testing for Syphilis Comparison of the Traditional and Reverse Screening Algorithms Disclosures Elli S. Theel, Ph.D. Director, Infectious Diseases Serology Laboratory Assistant Professor of Laboratory

More information

SYPHILIS (Treponema pallidum) IMMEDIATE NOTIFICATION STD PROGRAM

SYPHILIS (Treponema pallidum) IMMEDIATE NOTIFICATION STD PROGRAM SYPHILIS (Treponema pallidum) IMMEDIATE NOTIFICATION STD PROGRAM Event Name: Event Time Period: Clinical Description (CDC 2014) Syphilis 180 days Syphilis is a complex sexually transmitted disease that

More information

Syphilis Treatment Protocol

Syphilis Treatment Protocol STD, HIV, AND TB SECTION Syphilis Treatment Protocol CLINICAL GUIDANCE FOR PRIMARY AND SECONDARY SYPHILIS AND LATENT SYPHILIS www.lekarzol.com (4/2016) Page 1 of 8 Table of Contents Description... 3 Stages

More information

Guidance for Industry

Guidance for Industry Guidance for Industry Revised Recommendations for Donor and Product Management Based on Screening Tests for Syphilis DRAFT GUIDANCE This document is being distributed for comment purposes only. Submit

More information

Susanne Norris Zanto, MPH, MLS (ASCP) CM, SM Montana Public Health Laboratory

Susanne Norris Zanto, MPH, MLS (ASCP) CM, SM Montana Public Health Laboratory Susanne Norris Zanto, MPH, MLS (ASCP) CM, SM Montana Public Health Laboratory Describe the challenges in syphilis diagnostics Present two testing algorithms Non-treponemal test as initial screen Treponemal

More information

BMJ Open. Comparison of the automated rapid plasma reagin (RPR) test versus the conventional RPR card test in syphilis testing

BMJ Open. Comparison of the automated rapid plasma reagin (RPR) test versus the conventional RPR card test in syphilis testing Comparison of the automated rapid plasma reagin (RPR) test versus the conventional RPR card test in syphilis testing Journal: BMJ Open Manuscript ID: bmjopen-0-00 Article Type: Research Date Submitted

More information

Validation of a New Testing Algorithm for Syphilis in Trinidad & Tobago

Validation of a New Testing Algorithm for Syphilis in Trinidad & Tobago Validation of a New Testing Algorithm for Syphilis in Trinidad & Tobago R. Dass, A. Sebro, J. Edwards Ministry of Health, Trinidad and Tobago rianna.dass@hotmail.com, asebro@yahoo.com, jeffreye2000@gmail.com

More information

Background. Restricted Siemens Healthcare GmbH, >1 year Late latent syphilis. Restricted Siemens Healthcare GmbH, 2017

Background. Restricted Siemens Healthcare GmbH, >1 year Late latent syphilis. Restricted Siemens Healthcare GmbH, 2017 Background Nonneutralizing The Evolution of Syphilis Testing: Clinical Benefits of a Reverse Screening Algorithm Katherine Soreng PhD Lafond RE, et al. Clin Microbiol Rev. 06;19(1):29 49. Disease course:

More information

The Use of a Rapid Syphilis Test with Specimens from an HIV Cluster Investigation in Rural West Virginia

The Use of a Rapid Syphilis Test with Specimens from an HIV Cluster Investigation in Rural West Virginia National Center for HIV/AIDS, Viral Hepatitis, STD, and TB Prevention The Use of a Rapid Syphilis Test with Specimens from an HIV Cluster Investigation in Rural West Virginia Lara E. Pereira, Ph.D. Centers

More information

Performance Characteristics of the Reverse Syphilis Screening Algorithm in a Population With a Moderately High Prevalence of Syphilis

Performance Characteristics of the Reverse Syphilis Screening Algorithm in a Population With a Moderately High Prevalence of Syphilis Performance Characteristics of the Reverse Syphilis Screening Algorithm in a Population With a Moderately High Prevalence of Syphilis Angela R. Rourk, Frederick S. Nolte, PhD, and Christine M. Litwin,

More information

Syphilis Technical Instructions for Civil Surgeons

Syphilis Technical Instructions for Civil Surgeons National Center for Emerging and Zoonotic Infectious Diseases Syphilis Technical Instructions for Civil Surgeons Joanna J. Regan, MD, MPH, FAAP Medical Officer Medical Assessment and Policy Team Immigrant,

More information

Ann Dermatol Vol. 29, No. 6, 2017 https://doi.org/ /ad

Ann Dermatol Vol. 29, No. 6, 2017 https://doi.org/ /ad JI Kim, et al pissn 113-987ㆍeISSN 25-3894 Ann Dermatol Vol. 29, No. 6, 217 https://doi.org/1.521/ad.217.29.6.768 ORIGINAL ARTICLE Serologic Response to Treatment in Human Immunodeficiency Virus-Negative

More information

Analysis of 3 Algorithms for Syphilis Serodiagnosis and Implications for Clinical Management

Analysis of 3 Algorithms for Syphilis Serodiagnosis and Implications for Clinical Management MAJOR ARTICLE Analysis of 3 Algorithms for Syphilis Serodiagnosis and Implications for Clinical Management Man-Li Tong, 1,a Li-Rong Lin, 1,2,a Li-Li Liu, 1,2,3,a Hui-Lin Zhang, 1 Song-Jie Huang, 1 Yu-Yan

More information

Comparison of Automated Treponemal and Nontreponemal Test Algorithms as First-Line Syphilis Screening Assays

Comparison of Automated Treponemal and Nontreponemal Test Algorithms as First-Line Syphilis Screening Assays Original Article Diagnostic Immunology Ann Lab Med 2016;36:23-27 http://dx.doi.org/10.3343/alm.2016.36.1.23 ISSN 2234-3806 eissn 2234-3814 Comparison of Automated Treponemal and Nontreponemal Test Algorithms

More information

2/13/ Graphic photographs or cartoons used during this presentation might be offensive to some; for this I apologize in advance.

2/13/ Graphic photographs or cartoons used during this presentation might be offensive to some; for this I apologize in advance. Leon Bullard, MD, MA Medical Consultant, DHEC, DADE The 23 rd Annual APRN Conference Charleston, SC February 24, 2017 1. Provide a brief (very) review of the syphilis story. 2. Define and discuss the stages

More information

Analytical Comparison of the Architect Syphilis TP and Liaison Treponema Assay

Analytical Comparison of the Architect Syphilis TP and Liaison Treponema Assay JCM Accepted Manuscript Posted Online 16 May 2018 J. Clin. Microbiol. doi:10.1128/jcm.00215-18 Copyright 2018 American Society for Microbiology. All Rights Reserved. 1 2 3 Analytical Comparison of the

More information

4/18/2018. Syphilis Testing. Disclosure. Learner Objectives. Outline. Employee and stockholder of Bio-Rad Laboratories, Inc.

4/18/2018. Syphilis Testing. Disclosure. Learner Objectives. Outline. Employee and stockholder of Bio-Rad Laboratories, Inc. Disclosure Employee and stockholder of Bio-Rad Laboratories, Inc. Unraveling the Complexities of Syphilis Testing Maria Crisostomo, April 30 & May 1, 2018 2 Learner Objectives Syphilis Testing Upon completion

More information

Identifying false-positive syphilis antibody results using a semi-quantitative

Identifying false-positive syphilis antibody results using a semi-quantitative CVI Accepts, published online ahead of print on 20 April 2011 Clin. Vaccine Immunol. doi:10.1128/cvi.05066-11 Copyright 2011, American Society for Microbiology and/or the Listed Authors/Institutions. All

More information

Annals of Internal Medicine. 1991;114:

Annals of Internal Medicine. 1991;114: Serologic Response to Treatment of Infectious Syphilis Barbara Romanowski, MD; Ruth Sutherland, DPH, RN; Gordon H. Fick, PhD; Debbie Mooney, BSc; and Edgar J. Love, MD, PhD Objective: To evaluate the serologic

More information

NIH Public Access Author Manuscript Clin Infect Dis. Author manuscript; available in PMC 2009 October 1.

NIH Public Access Author Manuscript Clin Infect Dis. Author manuscript; available in PMC 2009 October 1. NIH Public Access Author Manuscript Published in final edited form as: Clin Infect Dis. 2008 October 1; 47(7): 893 899. doi:10.1086/591534. Normalization of Serum Rapid Plasma Reagin Titer Predicts Normalization

More information

To view an archived recording of this presentation please click the following link:

To view an archived recording of this presentation please click the following link: To view an archived recording of this presentation please click the following link: http://pho.adobeconnect.com/p16lj8z0qm3/ Please scroll down this file to view a copy of the slides from the session.

More information

Syphilis Testing in Northern California Kaiser

Syphilis Testing in Northern California Kaiser Syphilis Testing in Northern California Kaiser Jen Shieh, MS, CLS Test Development Scientist Kaiser Permanente TPMG Regional Laboratory Microbiology Department Kaiser Permanente 3.3 million members 22

More information

2019 HIV Diagnostics Conference March 27, 2019

2019 HIV Diagnostics Conference March 27, 2019 2019 HIV Diagnostics Conference March 27, 2019 Performance of the Syphilis Reverse Algorithm Using the Abbott Architect Syphilis TP (ASTP) and its Role in a Blended Diagnostic Application in Florida s

More information

The U.S. Preventive Services Task Force (USPSTF) makes

The U.S. Preventive Services Task Force (USPSTF) makes Annals of Internal Medicine Clinical Guidelines Screening for Syphilis Infection in Pregnancy: U.S. Preventive Services Task Force Reaffirmation Recommendation Statement U.S. Preventive Services Task Force*

More information

Treponema-Specific Tests for Serodiagnosis of Syphilis: Comparative Evaluation of Seven Assays

Treponema-Specific Tests for Serodiagnosis of Syphilis: Comparative Evaluation of Seven Assays JOURNAL OF CLINICAL MICROBIOLOGY, Apr. 2011, p. 1313 1317 Vol. 49, No. 4 0095-1137/11/$12.00 doi:10.1128/jcm.02555-10 Copyright 2011, American Society for Microbiology. All Rights Reserved. Treponema-Specific

More information

Discordant Results from Reverse Sequence Syphilis Screening Five Laboratories, United States,

Discordant Results from Reverse Sequence Syphilis Screening Five Laboratories, United States, Please note: An erratum has been published for this issue. To view the erratum, please click here. Morbidity and Mortality Weekly Report Weekly / Vol. 60 / No. 5 February 11, 2011 Discordant Results from

More information

Sexually transmitted infections (in women)

Sexually transmitted infections (in women) Sexually transmitted infections (in women) Timothy Kremer, MD Assistant Professor, Department of Obstetrics and Gynecology University of North Texas Health Science Center Last official CDC guidelines:

More information

test. It appeared that the MHA-TP test could be

test. It appeared that the MHA-TP test could be JOURNAL OF CLINICAL MICROBIOLOGY, Mar. 1983, p. 405-409 0095-1137/83/030405-05$02.00/0 Copyright 1983, American Society for Microbiology Vol. 17, No. 3 Reactivity of Microhemagglutination, Fluorescent

More information

WHAT DO U KNOW ABOUT STIS?

WHAT DO U KNOW ABOUT STIS? WHAT DO U KNOW ABOUT STIS? Rattiya Techakajornkeart MD. Bangrak STIs Cluster, Bureau of AIDS, TB and STIs, Department of Disease Control, MOPH, Thailand SEXUALLY TRANSMITTED INFECTIONS? STIs Infections

More information

Syphilis among MSM: Clinical Care and Public Health Reporting

Syphilis among MSM: Clinical Care and Public Health Reporting Massachusetts Department of Public Health Bureau of Infectious Disease and Laboratory Sciences Syphilis among MSM: Clinical Care and Public Health Reporting Kevin Ard, MD, MPH, Medical Director, National

More information

Treponemal-Specific Tests for the Serodiagnosis of Syphilis: A Comparative Evaluation of Seven Assays

Treponemal-Specific Tests for the Serodiagnosis of Syphilis: A Comparative Evaluation of Seven Assays JCM Accepts, published online ahead of print on 23 February 2011 J. Clin. Microbiol. doi:10.1128/jcm.02555-10 Copyright 2011, American Society for Microbiology and/or the Listed Authors/Institutions. All

More information

Sexually transmitted infections (in women)

Sexually transmitted infections (in women) Sexually transmitted infections (in women) Timothy Kremer, MD Assistant Professor, Department of Obstetrics and Gynecology University of North Texas Health Science Center Last official CDC guidelines:

More information

Documentation, Codebook, and Frequencies

Documentation, Codebook, and Frequencies Documentation, Codebook, and Frequencies MEC Laboratory Component: Syphilis(IgG), Syphilis Rapid Plasma Reagin (RPR), and Treponema pallidum Particle Agglutination (TP- PA) Survey Years: 2003 to 2004 SAS

More information

Evaluation of Reagin Screen, a New Serological Test for Syphilis

Evaluation of Reagin Screen, a New Serological Test for Syphilis JOURNAL OF CUNICAL MICROBIOLoGY, Aug. 1976, p. 145-150 Copyright 1976 American Society for Microbiology Vol. 4, No. 2 Printed in U.S.A. Evaluation of Reagin Screen, a New Serological Test for Syphilis

More information

9/9/2015. Began to see a shift in 2012 Early syphilis cases more than doubled from year before

9/9/2015. Began to see a shift in 2012 Early syphilis cases more than doubled from year before George Walton, MPH, CPH, MLS(ASCP) CM STD Program Manager Bureau of HIV, STD, and Hepatitis September 15, 2015 1 1) Discuss the changing epidemiology of syphilis in Iowa; 2) Explore key populations affected

More information

Syphilis. syphilis. Sera from all stages of syphilis and the. to compare dilution titers with those obtained

Syphilis. syphilis. Sera from all stages of syphilis and the. to compare dilution titers with those obtained JOURNAL OF CLINICAL MICROBIOLOGY, Feb. 1982, p. 238-242 0095-1137/82/020238-05$02.00/0 Vol. 15, No. 2 Unheated Serum Reagin Test as a Quantitative Test for Syphilis DEBORAH E. PETTIT, SANDRA A. LARSEN,*

More information

Screening for Syphilis Updated Evidence Report and Systematic Review for the US Preventive Services Task Force

Screening for Syphilis Updated Evidence Report and Systematic Review for the US Preventive Services Task Force Clinical Review & Education US Preventive Services Task Force EVIDENCE REPORT Screening for Syphilis Updated Evidence Report and Systematic Review for the US Preventive Services Task Force Amy G. Cantor,

More information

February 3, Division of Dockets Management (HFA 305) Food and Drug Administration 5630 Fishers Lane, Rm Rockville, MD 20852

February 3, Division of Dockets Management (HFA 305) Food and Drug Administration 5630 Fishers Lane, Rm Rockville, MD 20852 February 3, 2014 Division of Dockets Management (HFA 305) Food and Drug Administration 5630 Fishers Lane, Rm. 1061 Rockville, MD 20852 ATTN: Leslie Kux, Assistant Commissioner for Policy Ref: [Docket No.

More information

PROPOSED USE This method is used for determining plasma reagins in human sera.

PROPOSED USE This method is used for determining plasma reagins in human sera. Agglutination Assay -glass slide For "in vitro" use only Store at 2-8 C INTRODUCRION Syphilis is a sexually transmitted disease caused by Treponema pallidum. The main tests used to diagnose syphilis are:

More information

Public/Private Partnerships: Intervening in the Spread of Syphilis

Public/Private Partnerships: Intervening in the Spread of Syphilis Public/Private Partnerships: Intervening in the Spread of Diana Torres-Burgos MD, MPH Gerard Castaneda, BSN Alana Thomas, BS STD/HIV Update Conference Grand Rapids, MI 3/11/2014 Outline overview Stages

More information

Syphilis Update: New Presentations of an Old Disease

Syphilis Update: New Presentations of an Old Disease Syphilis Update: New Presentations of an Old Disease Bradley Stoner, MD, PhD Washington University in St. Louis Disclosure: Bradley Stoner, MD, PhD STDs in the United States Where do we stand right now?

More information

VDRL v/s TPHA for diagnosis of syphilis among HIV sero-reactive patients in a tertiary care hospital

VDRL v/s TPHA for diagnosis of syphilis among HIV sero-reactive patients in a tertiary care hospital ISSN: 2319-7706 Volume 3 Number 5 (2014) pp. 726-730 http://www.ijcmas.com Original Research Article VDRL v/s TPHA for diagnosis of syphilis among HIV sero-reactive patients in a tertiary care hospital

More information

Spirochetes. Treponema pallidum

Spirochetes. Treponema pallidum Spirochetes Treponema pallidum Dr. Hala Al Daghistani - Spirochetes are a large, heterogeneous group of spiral, motile bacteria. - One family Spirochaetaceae consists of two genera whose members are human

More information

Evaluation of a New Rapid Plasma Reagin Card Test as a Screening Test for Syphilis

Evaluation of a New Rapid Plasma Reagin Card Test as a Screening Test for Syphilis JOURNAL OF CLINICAL MICROBIOLOGY, Aug. 1982, p. 286-290 0095-1 137/82/080286-05$02.00/0 Vol. 16, No. 2 Evaluation of a New Rapid Plasma Reagin Card Test as a Screening Test for Syphilis MARY W. PERRYMAN,'*

More information

Clinical Application of New Treponemal Antibody Test in Blood Donors

Clinical Application of New Treponemal Antibody Test in Blood Donors Clinical Application of New Treponemal Antibody Test in Blood Donors Parichart Permpikul, MD Department of Transfusion Medicine Faculty of Medicine Siriraj Hospital Mahidol University Bangkok, Thailand

More information

Guidance for Industry

Guidance for Industry Reprinted from FDA s website by Guidance for Industry Recommendations for Screening, Testing, and Management of Blood Donors and Blood and Blood Components Based on Screening Tests for Syphilis DRAFT GUIDANCE

More information

Sexually Transmitted Disease Treatment Tables

Sexually Transmitted Disease Treatment Tables Sexually Transmitted Disease Treatment Tables Federal Bureau of Prisons Clinical Practice Guidelines June 2011 Clinical guidelines are made available to the public for informational purposes only. The

More information

INFECTIOUS SYPHILIS NOTIFICATION FORM

INFECTIOUS SYPHILIS NOTIFICATION FORM INFECTIOUS SYPHILIS NOTIFICATION FORM This is a Schedule 1, Section C disease notifiable to the Medical Officer of Health under Sections 74 and 74AA of the Health Act 1956 using non-identifiable data.

More information

Guidance for Industry

Guidance for Industry Reprinted from FDA s website by EAS Consulting Group, LLC Guidance for Industry Recommendations for Screening, Testing, and Management of Blood Donors and Blood and Blood Components Based on Screening

More information

Learning Objectives. Syphilis. Lessons. Epidemiology: Disease in the U.S. Syphilis Definition. Transmission. Treponema pallidum

Learning Objectives. Syphilis. Lessons. Epidemiology: Disease in the U.S. Syphilis Definition. Transmission. Treponema pallidum Learning Objectives Syphilis Treponema pallidum 1 Upon completion of this content, the learner will be able to 1. Describe the epidemiology of syphilis in the U.S. 2. Describe the pathogenesis of T. pallidum.

More information

Case 1. Case 1. Physical exam

Case 1. Case 1. Physical exam 11/13/2012 Case 28 year-old woman Complains of very painful lesions in vulvar area Increasing severity since 4 days Pain aggravated by urination She has a slight fever and also complains of headache and

More information

SYPHILIS. The Great Pretender K. Amen Eguakun, MSN, APRN, AAHIVS

SYPHILIS. The Great Pretender K. Amen Eguakun, MSN, APRN, AAHIVS SYPHILIS The Great Pretender K. Amen Eguakun, MSN, APRN, AAHIVS Learning Objectives At the end of this presentation, the participants will be able to 1. Describe the epidemiology of syphilis in the United

More information

Sexually Transmitted Diseases Treatment Guidelines, 2015

Sexually Transmitted Diseases Treatment Guidelines, 2015 Morbidity and Mortality Weekly Report Recommendations and Reports / Vol. 64 / No. 3 June 5, 2015 Sexually Transmitted Diseases Treatment Guidelines, 2015 U.S. Department of Health and Human Services Centers

More information

Didactic Series. STD Screening & Management: Syphilis. Christian B. Ramers, MD, MPH

Didactic Series. STD Screening & Management: Syphilis. Christian B. Ramers, MD, MPH Didactic Series STD Screening & Management: Syphilis Christian B. Ramers, MD, MPH Assistant Medical Director Family Health Centers of San Diego Ciaccio Memorial Clinic 3/26/15 ACCREDITATION STATEMENT:

More information

Screening for Syphilis With the Treponemal Immunoassay: Analysis of Discordant Serology Results and Implications for Clinical Management

Screening for Syphilis With the Treponemal Immunoassay: Analysis of Discordant Serology Results and Implications for Clinical Management MAJOR ARTICLE Screening for Syphilis With the Treponemal Immunoassay: Analysis of Discordant Serology Results and Implications for Clinical Management Ina U. Park, 1,2 Joan M. Chow, 1 Gail Bolan, 1 Mark

More information

The Great Imitator Revealed: Syphilis

The Great Imitator Revealed: Syphilis The Great Imitator Revealed: Syphilis Jeffrey D. Klausner, MD, MPH Professor of Medicine and Public Health University of California Los Angeles David Geffen School of Medicine Los Angeles, California Learning

More information

STDs in HIV Clinical Care: New Guidelines on Treatment and Prevention

STDs in HIV Clinical Care: New Guidelines on Treatment and Prevention STDs in HIV Clinical Care: New Guidelines on Treatment and Prevention Palliative Care Conference Faculty Development Conference August 13, 2015 Steven C. Johnson M.D. Director, University of Colorado HIV/AIDS

More information

Novel Point-of-Care Test for Simultaneous Detection of Nontreponemal and Treponemal Antibodies in Patients with Syphilis

Novel Point-of-Care Test for Simultaneous Detection of Nontreponemal and Treponemal Antibodies in Patients with Syphilis JOURNAL OF CLINICAL MICROBIOLOGY, Dec. 2010, p. 4615 4619 Vol. 48, No. 12 0095-1137/10/$12.00 doi:10.1128/jcm.00624-10 Copyright 2010, American Society for Microbiology. All Rights Reserved. Novel Point-of-Care

More information

A Novel Point-of-Care Test for the Simultaneous Detection of Non-Treponemal and Treponemal Antibodies in Patients with Syphilis

A Novel Point-of-Care Test for the Simultaneous Detection of Non-Treponemal and Treponemal Antibodies in Patients with Syphilis JCM Accepts, published online ahead of print on 29 September 2010 J. Clin. Microbiol. doi:10.1128/jcm.00624-10 Copyright 2010, American Society for Microbiology and/or the Listed Authors/Institutions.

More information

Comparison of Doxycycline and Benzathine Penicillin G for the Treatment of Early Syphilis

Comparison of Doxycycline and Benzathine Penicillin G for the Treatment of Early Syphilis 2017;25(2):107-111 Clinical article Comparison of Doxycycline and Benzathine Penicillin G for the Treatment of Early Syphilis Hailu Xiao *1,2,3, Dianchang Liu *1,2,4, Zhen Li 1,2,4, Rongtao Zheng 1,2,4,

More information

Lisa Villarroel, MD MPH Medical Director, Division of Public Health Preparedness Arizona Department of Health Services.

Lisa Villarroel, MD MPH Medical Director, Division of Public Health Preparedness Arizona Department of Health Services. Lisa Villarroel, MD MPH Medical Director, Division of Public Health Preparedness Arizona Department of Health Services Disclosures: None 1 PRIMARY Fitzgerald TJ, Cleveland P, Johnson RC et al: Scanning

More information

Current standards for diagnosis and treatment of syphilis: selection of some practical issues, based on the European (IUSTI) and U.S.

Current standards for diagnosis and treatment of syphilis: selection of some practical issues, based on the European (IUSTI) and U.S. Special paper Current standards for diagnosis and treatment of syphilis: selection of some practical issues, based on the European (IUSTI) and U.S. (CDC) guidelines Maciej Pastuszczak, Anna Wojas-Pelc

More information

Evaluation of Treponemal Serum Tests Performed on Cerebrospinal Fluid for Diagnosis of Neurosyphilis

Evaluation of Treponemal Serum Tests Performed on Cerebrospinal Fluid for Diagnosis of Neurosyphilis Evaluation of Treponemal Serum Tests Performed on Cerebrospinal Fluid for Diagnosis of Neurosyphilis Jeannette Guarner, Emory University Heather Jost, Emory University Allan Pillay, Emory University Yongcheng

More information

Annual Epidemiological Report

Annual Epidemiological Report Annual Epidemiological Report November 2018 Key Facts 1 Early infectious syphilis in Ireland, 2017 There were 398 confirmed cases of early infectious syphilis (EIS) notified in 2017 The notification rate

More information

Performance of Syphilis Sentinel Surveillance in the context of endemic Treponematoses: experience from Ghana

Performance of Syphilis Sentinel Surveillance in the context of endemic Treponematoses: experience from Ghana Dassah et al. BMC Infectious Diseases (2016) 16:745 DOI 10.1186/s12879-016-2085-y RESEARCH ARTICLE Performance of Syphilis Sentinel Surveillance in the context of endemic Treponematoses: experience from

More information

Syphilis. sera from the Venereal Disease Serology Laboratory. Serum Bank, Centers for Disease Control, Atlanta,

Syphilis. sera from the Venereal Disease Serology Laboratory. Serum Bank, Centers for Disease Control, Atlanta, JOURNAL OF CLINICAL MICROBIOLOGY, Oct. 1981, p. 441-445 0095-1137/81/0441-05$02.00/0 Vol. 14, No. 4 Specificity, Sensitivity, and Reproducibility Among the Fluorescent Treponemal Antibody-Absorption Test,

More information

Nothing to disclose.

Nothing to disclose. Update on Diagnosis and Treatment Lisa Winston, MD University of California, San Francisco/ Zuckerberg San Francisco General Nothing to disclose. 1 This talk will be a little depressing Rising incidence

More information

Interpreting Syphilis Serology

Interpreting Syphilis Serology Interpreting Syphilis Serology Dr Beng Goh Royal London Hospital Barts & The London NHS Trust beng.goh@bartsandthelondon.nhs.uk Serological Tests for Syphilis: Principles Screening Confirmation Staging

More information

Edward W. Hook, III, M.D.

Edward W. Hook, III, M.D. Challenging Cases Edward W. Hook III M.D. Professor and Director Division of Infectious Diseases University of Alabama at Birmingham And PI, Alabama/North Carolina STD PTC Edward W. Hook, III, M.D. Grant/Research

More information

Neurosyphilis as an Emerging Feature in the HIV Setting. Christina M. Marra, MD University of Washington Seattle, WA, USA

Neurosyphilis as an Emerging Feature in the HIV Setting. Christina M. Marra, MD University of Washington Seattle, WA, USA Neurosyphilis as an Emerging Feature in the HIV Setting Christina M. Marra, MD University of Washington Seattle, WA, USA Syphilis in the Developing World Region 1995 1999 Sub-Saharan 3,530,000 3,828,000

More information

6/11/15. BACTERIAL STDs IN A POST- HIV WORLD. Learning Objectives. How big a problem are STIs in the U.S.?

6/11/15. BACTERIAL STDs IN A POST- HIV WORLD. Learning Objectives. How big a problem are STIs in the U.S.? BACTERIAL STDs IN A POST- HIV WORLD Tracey Graney, PhD, MT(ASCP) Monroe Community College Learning Objectives Describe the epidemiology and incidence of bacterial STDs in the U.S. Describe current detection

More information

Evaluation of a Fully Automated Treponemal Test and Comparison With Conventional VDRL and FTA-ABS Tests

Evaluation of a Fully Automated Treponemal Test and Comparison With Conventional VDRL and FTA-ABS Tests Immunopathology / Evaluation of an Automated Treponemal Test Evaluation of a Fully Automated Treponemal Test and Comparison With Conventional VDRL and FTA-ABS Tests Yongjung Park, MD, 1 Younhee Park, MD,

More information

Frequent Screening for Syphilis as Part of HIV Monitoring Increases the Detection of Early Asymptomatic Syphilis Among HIV-Positive Homosexual Men

Frequent Screening for Syphilis as Part of HIV Monitoring Increases the Detection of Early Asymptomatic Syphilis Among HIV-Positive Homosexual Men CLINICAL SCIENCE Frequent Screening for Syphilis as Part of HIV Monitoring Increases the Detection of Early Asymptomatic Syphilis Among HIV-Positive Homosexual Men Melanie Bissessor, FRACGP,* Christopher

More information

Results of the 2014 Survey

Results of the 2014 Survey Syphilis Testing Practices in the Region of the Americas: 1 Syphilis Testing Practices in the Americas Region: Washington, D.C. 2016 Prepared by: Thuy Trinh¹, Mary L Kamb¹, Minh Luu², D. Cal Ham¹, Freddy

More information

Antibodies to Treponema pallidum

Antibodies to Treponema pallidum APPLIED MICROBIOLOGY, July 1972, p. 26- Copyright 0 1972 American Society for Microbiology Vol. 24, No. 1 Printed in U.S.A. Evaluation of the Qualitative and Automated Quantitative Microhemagglutination

More information

Evaluation of the LIAISON Treponema Assay, a Chemiluminescent Immunoassay ACCEPTED

Evaluation of the LIAISON Treponema Assay, a Chemiluminescent Immunoassay ACCEPTED CVI Accepts, published online ahead of print on 25 April 2007 Clin. Vaccine Immunol. doi:10.1128/cvi.00068-07 Copyright 2007, American Society for Microbiology and/or the Listed Authors/Institutions. All

More information

Wei-Qiang He, Huan-Li Wang, Dao-Qing Zhong, Lu-Yang Lin, Xiao-Shan Qiu, Ri-Dong Yang

Wei-Qiang He, Huan-Li Wang, Dao-Qing Zhong, Lu-Yang Lin, Xiao-Shan Qiu, Ri-Dong Yang Int J Clin Exp Pathol 2015;8(5):5775-5780 www.ijcep.com /ISSN:1936-2625/IJCEP0006331 Original Article Treponemal antibody in CSF and cellular immunity in peripheral blood of syphilitic patients with persisting

More information

Early syphilis: serological treatment response to doxycycline/tetracycline versus benzathine penicillin

Early syphilis: serological treatment response to doxycycline/tetracycline versus benzathine penicillin Brief Original Article Early syphilis: serological treatment response to doxycycline/tetracycline versus benzathine penicillin Jun Li, He-Yi Zheng Department of Dermatology and Venereology, Peking Union

More information

Medical Bacteriology Lecture 11

Medical Bacteriology Lecture 11 Medical Bacteriology Lecture 11 Spirochaetaceae Treponema Borrelia 1 Spirochaetaceae Characteristics - Gran negative rods - spiral single cells, or cork-screw-shaped, extremely thin and can be very long

More information

CHAPTER-X SYPHILIS R.KAVITHA, M.PHARM, LECTURER, DEPARTMENT OF PHARMACEUTICS, SRM COLLEGE OF PHARMACY, SRM UNIVERSITY, KATTANKULATHUR.

CHAPTER-X SYPHILIS R.KAVITHA, M.PHARM, LECTURER, DEPARTMENT OF PHARMACEUTICS, SRM COLLEGE OF PHARMACY, SRM UNIVERSITY, KATTANKULATHUR. CHAPTER-X SYPHILIS R.KAVITHA, M.PHARM, LECTURER, DEPARTMENT OF PHARMACEUTICS, SRM COLLEGE OF PHARMACY, SRM UNIVERSITY, KATTANKULATHUR. Trepanoma pallidum D. Clinical Infection: Syphilis Transmission Usually

More information

EVALUATION OF ENZYME IMMUNOASSAY AND IMMUNOBLOT TESTING FOR THE DIAGNOSIS OF SYPHILIS IN ALBERTA

EVALUATION OF ENZYME IMMUNOASSAY AND IMMUNOBLOT TESTING FOR THE DIAGNOSIS OF SYPHILIS IN ALBERTA EVALUATION OF ENZYME IMMUNOASSAY AND IMMUNOBLOT TESTING FOR THE DIAGNOSIS OF SYPHILIS IN ALBERTA Arto Ohinmaa, Anderson Chuck, Thanh Nguyen, Janice Varney, Philip Jacobs Supported by a financial contribution

More information

5/1/2017. Sexually Transmitted Diseases Burning Questions

5/1/2017. Sexually Transmitted Diseases Burning Questions Sexually Transmitted Diseases Burning Questions Jeffrey D. Klausner, MD, MPH Professor of Medicine and Public Health University of California Los Angeles Los Angeles, California FORMATTED: 04-03-17 Financial

More information

T. pallidum IgG ELISA Kit

T. pallidum IgG ELISA Kit T. pallidum IgG ELISA Kit Catalog Number KA3136 96 assays Version: 01 Intended for research use only www.abnova.com Table of Contents Introduction... 3 Intended Use... 3 Background... 3 Principle of the

More information

Evaluation of a Treponema pallidum Enzyme Immunoassay as a Screening Test for Syphilis

Evaluation of a Treponema pallidum Enzyme Immunoassay as a Screening Test for Syphilis CLINICAL AND DIAGNOSTIC LABORATORY IMMUNOLOGY, JUly 1994, p. 477-481 Vol. 1, No. 4 1071-412X/94/$04.00+0 Copyright C 1994, American Society for Microbiology Evaluation of a Treponema pallidum Enzyme Immunoassay

More information

Performance of SD Bioline Syphilis 3.0 for the Diagnosis of Syphilis a UPFR in Immunology of CHU-JRA

Performance of SD Bioline Syphilis 3.0 for the Diagnosis of Syphilis a UPFR in Immunology of CHU-JRA International Journal of Current Microbiology and Applied Sciences ISSN: 2319-7706 Volume 6 Number 8 (2017) pp. 783-788 Journal homepage: http://www.ijcmas.com Original Research Article https://doi.org/10.20546/ijcmas.2017.608.099

More information

Screening or confirmatory test?

Screening or confirmatory test? J Clin Pathol 1992;45:37-41 Department of Medical Microbiology, University Medical School, Edinburgh EH8 9AG H Young A Moyes Genitourinary Medicine Unit, Edinburgh Royal Infirmary A McMillan J Patterson

More information

Dr. R. Someshwaran, MBBS, MD., Assistant professor, Dept. of Microbiology, KFMS&R

Dr. R. Someshwaran, MBBS, MD., Assistant professor, Dept. of Microbiology, KFMS&R Dr. R. Someshwaran, MBBS, MD., Assistant professor, Dept. of Microbiology, KFMS&R 1 What is Syphilis? Syphilis is a systemic, sexually transmitted disease (STD) caused by the Treponema pallidum bacterium.

More information

9.1 Overview and General Guidance This section contains information on the laboratory procedures performed in MTN-035.

9.1 Overview and General Guidance This section contains information on the laboratory procedures performed in MTN-035. Section 9. Laboratory Considerations 9. Introduction... 9-1 9.1 Overview and General Guidance... 9-1 9.2 Specimen Labeling... 9-4 9.3 Procedures for Specimens that cannot be Evaluated... 9-4 9.4 Use of

More information

SYPHILIS HEALTH CHECK

SYPHILIS HEALTH CHECK SYPHILIS HEALTH CHECK Rev. P, 02/17 CLIA Complexity: WAIVED for Fingerstick Whole Blood Specimens ONLY For in vitro diagnostic use only Rx Only A Certificate of Waiver is required to perform this test

More information

Management of Syphilis in Patients with HIV

Management of Syphilis in Patients with HIV Management of Syphilis in Patients with HIV Adult Clinical Guideline from the New York State Department of Health AIDS Institute www.hivguidelines.org Purpose of the Guideline Increase the numbers of NYS

More information

Medical Bacteriology- Lecture 13 Spirochaetales 1- Spirochaetaceae Treponema Borrelia 2- Leptospiraceae Leptospira

Medical Bacteriology- Lecture 13 Spirochaetales 1- Spirochaetaceae Treponema Borrelia 2- Leptospiraceae Leptospira Medical Bacteriology- Lecture 13 Spirochaetales 1- Spirochaetaceae Treponema Borrelia 2- Leptospiraceae Leptospira OS = outer sheath AF = axial fibrils AF Leptospira interrogans Characteristics: Spirochaetaceae

More information

Dermatologist Venereologist MD, PhD

Dermatologist Venereologist MD, PhD Vassiliki Mousatou Dermatologist Venereologist MD, PhD Genital warts Genital herpes Syphilis Gonococcal and no gonococcal urethritis HIV Hepatitis B and C Also: Lymphogranuloma venereum and Granuloma

More information

Syphilis Screening in the Community

Syphilis Screening in the Community Syphilis Screening in the Community A NJ DOH DHSTS Pilot Project Eugene G. Martin, Ph.D Co-Director, NJ HIV Professor of Pathology and Laboratory Medicine Rutgers University Robert Wood Johnson Medical

More information

Division of Dermatology Dr A Motau

Division of Dermatology Dr A Motau Division of Dermatology Dr A Motau CASE 1 Histopathology H&E H&E H&E Wartin Starry Immunohistochemical stain for T. pallidum Investigations FBC, U&E, LFT Normal T. pallidum Abs Reactive RPR screen

More information

MID 15. Syphilis. Simon Tsiouris, MD, MPH. 1. Introduction

MID 15. Syphilis. Simon Tsiouris, MD, MPH. 1. Introduction Syphilis Simon Tsiouris, MD, MPH 1. Introduction Syphilis is a chronic infection caused by the bacterium Treponema pallidum which was first described over 500 years ago. The manifestations of disease are

More information