High Number of Positive Rapid Plasma Reagin With Low Titers Using the Automated AIX 1000 RPR System

Palavecino, Elizabeth; Soltani, Sohaila; Keller, Ryan; Elliott, Stephanie; McNeil, Candice J

doi:10.1097/olq.0000000000001499

Cited by 2 publications

(1 citation statement)

References 3 publications

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“…Sanfilippo et al 10 showed a false-positive rate of 43.6% for the RPR-A at an initial screening, which was solved by including a second screen at the time of titer determination. Also, Palavecino et al 13 registered an increase in positive samples with a low RPR-A titer (5.8%) compared with manual RPR (3%), of which 57% were false positive. The high number of false-positive results is likely related to the low prevalence in these studies and is likely lower when using the reverse algorithm.…”

Section: Discussionmentioning

confidence: 98%

Evaluation of the AIX1000 Automated Rapid Plasma Reagin Assay in a High-Prevalence Setting

et al. 2023

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Section: Discussionmentioning

confidence: 98%

Evaluation of the AIX1000 Automated Rapid Plasma Reagin Assay in a High-Prevalence Setting

et al. 2023

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Combination of Amoxicillin 3000 mg and Probenecid Versus 1500 mg Amoxicillin Monotherapy for Treating Syphilis in Patients With Human Immunodeficiency Virus: An Open-Label, Randomized, Controlled, Non-Inferiority Trial

Ando

Mizushima

Omata

et al. 2023

Clinical Infectious Diseases

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Background Amoxicillin plus probenecid is an alternative to intramuscular benzathine penicillin G for treating syphilis in the United Kingdom. Low-dose amoxicillin is an alternative treatment option used in Japan. Methods We conducted an open-label, randomized, controlled, non-inferiority trial between August 31, 2018, and February 3, 2022, to compare 1,500 mg low-dose amoxicillin monotherapy with the combination of 3,000 mg amoxicillin and probenecid (non-inferiority margin 10%). Patients with human immunodeficiency virus (HIV) infection and syphilis were eligible. The primary outcome was the cumulative serological cure rate within 12 months post-treatment, measured using the manual rapid plasma reagin card test. Secondary outcomes included safety assessment. Results A total of 112 participants were randomized into two groups. Serological cure rates within 12 months were 90.6% and 94.4% with the low-dose amoxicillin and combination regimens, respectively. Serological cure rates for early syphilis within 12 months were 93.5% and 97.9% with the low-dose amoxicillin and combination regimens, respectively. Non-inferiority of low-dose amoxicillin compared with amoxicillin plus probenecid overall and for early syphilis was not confirmed. No significant side effects were detected. Conclusion This is the first randomized controlled trial to demonstrate a high efficacy of amoxicillin-based regimens for treating syphilis in patients with HIV infection, and the non-inferiority of low-dose amoxicillin compared with amoxicillin plus probenecid was not seen. Therefore, amoxicillin monotherapy could be a good alternative to intramuscular benzathine penicillin G with fewer side effects. However, further studies comparing with benzathine penicillin G in different populations and with larger sample sizes are needed. Clinical trials registration University Hospital Medical Information Network (UMIN000033986)

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High Number of Positive Rapid Plasma Reagin With Low Titers Using the Automated AIX 1000 RPR System

Cited by 2 publications

References 3 publications

Evaluation of the AIX1000 Automated Rapid Plasma Reagin Assay in a High-Prevalence Setting

Evaluation of the AIX1000 Automated Rapid Plasma Reagin Assay in a High-Prevalence Setting

Combination of Amoxicillin 3000 mg and Probenecid Versus 1500 mg Amoxicillin Monotherapy for Treating Syphilis in Patients With Human Immunodeficiency Virus: An Open-Label, Randomized, Controlled, Non-Inferiority Trial

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