PCR detection for syphilis diagnosis: Status and prospects

Zhou, Chenglong; Zhang, Xiao­hong; Zhang, Wei; Duan, Junxia; Zhao, Feijun

doi:10.1002/jcla.22890

Cited by 50 publications

(43 citation statements)

References 47 publications

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“…PCR testing for syphilis is also an ongoing area of interest. There are various types of PCR testing; however, none are approved by the FDA and PCR testing for syphilis remains costly [99]. PCR is best for detecting primary syphilis with swabs from chancres although it would amplify both live and dead organisms.…”

Section: Testingmentioning

confidence: 99%

The Intersection of HIV and Syphilis: Update on the Key Considerations in Testing and Management

2021

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Purpose of Review To highlight recent trends in the epidemiology of HIV and syphilis, the impact of the COVID epidemic, our approach to care of co-infected patients, and our views on important next steps in advancing the field. Recent Findings HIV and syphilis co-infection has been on the rise in recent years although since the COVID pandemic there is a decrease in new diagnoses—it remains unclear if this represents a true decline or inadequate testing or under-reporting. Standard HIV care should include regular syphilis serology .Treatment and serological follow-up of syphilis in HIV positive and negative patients can be conducted similarly. Challenges remain in the diagnosis and management of neurosyphilis. New models for testing and prevention will be crucial next steps in controlling co-infection. Summary The intersection of HIV and syphilis infections continues to pose new and unique challenges in diagnosis, treatment, and prevention.

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Section: Testingmentioning

confidence: 99%

The Intersection of HIV and Syphilis: Update on the Key Considerations in Testing and Management

2021

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“…In early and primary syphilis, serum and CSF sensitivity of PCR testing is close to 90% and specificity close to 100%. The sensitivity drops dramatically to 50% in secondary syphilis [ 20 ].…”

Section: Discussionmentioning

confidence: 99%

Decomplexifying Serum and Cerebrospinal Fluid (CSF) Serologic Testing of Neurosyphilis: A Case Report of Ocular Syphilis and Highlights of the Principles of Serologic Testing

Kesserwani¹

2020

Cureus

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Serologic tests for syphilis can be quite complex. The screening and confirmatory tests, which number at least eight, are mathematically interpreted as a total of 16 possible combinations, if we choose one test from each of two sets of four. However, this bewildering complexity is simplified if we apply certain principles. We reiterate and propose four axioms. First, we distinguish between treponemal versus non-treponemal tests. The former, the treponemal test, is specific for the spirochete, treponema pallidum, and is used as a confirmatory test. It rarely declines over time. The latter, the non-treponemal test, is a screening test and reflects treponemal or tissue damage, is reported as a titer, and is used to monitor disease activity. We usually need both for screening and confirmatory diagnostic testing. Secondly, for rapid plasma reagin (RPR) tests, a non-treponemal serology test titer of at least 1:8 is suggestive of syphilis, but not necessarily neurosyphilis. A false-negative test usually registers below this dilution level and may be due to the “prozone phenomenon”. Serum RPR titers are usually greater than 1:32. Thirdly, a negative treponemal test in the cerebrospinal fluid excludes neurosyphilis and a positive test is highly sensitive but lacks specificity, usually due to blood contamination. Most patients with neurosyphilis will have a positive non-treponemal test in the cerebrospinal fluid (CSF) with elevated protein and pleocytosis. Fourthly, a serological cure is defined as at least a four-fold decline in a non-treponemal test titer at three and six months, or a persistently low titer after treatment. Patients who do not fulfill these criteria are known as “serofast”. We describe the case of a 38-year-old man with human immunodeficiency virus-type 1 who developed bilateral optic disc edema with photopsias and transient visual obscurations.

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“…Another multiplex assay, the FilmArray ® (BioFire Diagnostics, Salt Lake City, UT, USA), can detect up to nine STIs (CT, GC, TV, MG, and UU, plus TP, Haemophilus ducreyi, and HSV 1 and 2) [71]. Several PCR-based assays have been developed specifically for the detection of T. pallidum, not only from genital swabs and lesions, but also from blood and cerebrospinal fluid [74], and even semen [75]. Although they show high sensitivity and specificity, these tests are not commercially available and their use is limited to some laboratories [49].…”

Section: Pcr-based Assaysmentioning

confidence: 99%

Current and Future Trends in the Laboratory Diagnosis of Sexually Transmitted Infections

Caruso

Giammanco

Virruso

et al. 2021

IJERPH

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Sexually transmitted infections (STIs) continue to exert a considerable public health and social burden globally, particularly for developing countries. Due to the high prevalence of asymptomatic infections and the limitations of symptom-based (syndromic) diagnosis, confirmation of infection using laboratory tools is essential to choose the most appropriate course of treatment and to screen at-risk groups. Numerous laboratory tests and platforms have been developed for gonorrhea, chlamydia, syphilis, trichomoniasis, genital mycoplasmas, herpesviruses, and human papillomavirus. Point-of-care testing is now a possibility, and microfluidic and high-throughput omics technologies promise to revolutionize the diagnosis of STIs. The scope of this paper is to provide an updated overview of the current laboratory diagnostic tools for these infections, highlighting their advantages, limitations, and point-of-care adaptability. The diagnostic applicability of the latest molecular and biochemical approaches is also discussed.

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PCR detection for syphilis diagnosis: Status and prospects

Cited by 50 publications

References 47 publications

The Intersection of HIV and Syphilis: Update on the Key Considerations in Testing and Management

The Intersection of HIV and Syphilis: Update on the Key Considerations in Testing and Management

Decomplexifying Serum and Cerebrospinal Fluid (CSF) Serologic Testing of Neurosyphilis: A Case Report of Ocular Syphilis and Highlights of the Principles of Serologic Testing

Current and Future Trends in the Laboratory Diagnosis of Sexually Transmitted Infections

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