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Syphilis Tests

What Affects the Test

Reasons you may not be able to have the test or why the results may not be helpful include:

  • The use of antibiotics before having the test.
  • A blood transfusion in the weeks before having the test.
  • Having other conditions or diseases, such as lupus, liver disease, HIV infection, or a tropical bacterial infection called yaws.

What To Think About

Most states require doctors to report all cases of syphilis to the local health department. In some states, doctors are also required to ask for the names and addresses of your recent sex partners. If you have syphilis, the health department may contact you to make sure that you get treatment. If you give the names of your sex partners to your doctor or the health department, they will be contacted in confidence by the health department and advised to have a test for syphilis.

About results

  • If a screening test is positive (reactive), the strength of the result may be determined by measuring the amount of reagin. The results are then given in titers.
  • A reactive or positive test result does not always mean that you have syphilis. Other conditions can cause positive screening test results, including injecting illegal drugs, recent vaccinations, endocarditis, autoimmune diseases (such as systemic lupus erythematosus, or SLE), tuberculosis, mononucleosis, leprosy, malaria, hepatitis, Lyme disease, rheumatoid arthritis, and in rare cases, pregnancy.
  • With treatment, a positive reagin (VDRL and RPR) syphilis test result usually becomes negative. Positive treponemal (FTA-ABS, MHA-TP, TPPA) tests stay positive for a lifetime.

Syphilis and HIV infection

  • Sores caused by syphilis (chancres) make it easier to get and spread an HIV infection.
  • People with HIV infection who have a negative VDRL test should have a second test for syphilis if the infection is suspected.

Citations

  1. Centers for Disease Control and Prevention (2010). Syphilis section of Sexually transmitted diseases treatment guidelines, 2010. MMWR, 59(RR-12): 26-39. Also available online: http://www.cdc.gov/std/treatment/2010/default.htm.

  2. U.S. Preventive Services Task Force (2009). Screening for syphilis infection in pregnancy: U.S. Preventive Services Task Force reaffirmation recommendation statement. Annals of Internal Medicine, 150(10): 705–709.

Other Works Consulted

  • Chernecky CC, Berger BJ (2013). Laboratory Tests and Diagnostic Procedures, 6th ed. St. Louis: Saunders.

  • Fischbach FT, Dunning MB III, eds. (2009). Manual of Laboratory and Diagnostic Tests, 8th ed. Philadelphia: Lippincott Williams and Wilkins.

ByHealthwise Staff
Primary Medical ReviewerSarah Marshall, MD - Family Medicine
Specialist Medical ReviewerDevika Singh, MD, MPH - Infectious Disease
Last RevisedSeptember 29, 2011
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WebMD Medical Reference from Healthwise

Last Updated: September 29, 2011
This information is not intended to replace the advice of a doctor. Healthwise disclaims any liability for the decisions you make based on this information.

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