Treponemal Specific Tests for the Serodiagnosis of Syphilis

Abstract

The MHA-TP may be less sensitive than the FTA-ABS for identifying patients with primary syphilis. Treponemal specific tests may become nonreactive during the first year after therapy for early syphilis.

Syphilis in the HIV-infected patient: An update on epidemiology, diagnosis, and management

“…More recent data show that, at least in a short follow-up period, the rate of treponemal serologic test seroreversion does not differ in HIV-seropositive and HIV-seronegative patients with early-stage syphilis [24]. Seroreversion seems to be common in both groups.…”

Serologic Response to Treatment in Syphilis

“…After adjustment for the CD4 cell count, only TPHA titer had significant decrease and seroreversion in HIV positive patients (French et al, 2009). However, another study found no association between HIV seropositivity and seroreversion of treponemal antibodies, in patients treated for early syphilis (Augenbraun et al, 1998). Also, seroreversion of treponemal antibodies had been reported in immunocompetent patients treated for early syphilis (Schroeter et al, 1972) or first episode of syphilis (Romanowski et al, 1991).…”

“…After 1 year follow-up, 14% of patients were serologically defined as treatment failures; the serologic failure rate was higher in HIV infected patients. Enhanced treatment with amoxicillin and probenecid did not improve the outcomes, and the authors concluded that CDC recommendations for treating early syphilis are adequate for most patients, whether or not they have HIV infection (Augenbraun et al, 1998). Ghanem and collaborators performed a comparative study of serological response to syphilis treatment in 129 HIV positive and 168 HIV negative patients attending sexually transmitted diseases clinics between 1992 and 2000.…”

“…A prospective, cohort treatment study of 261 patients with early syphilis that had 1 year serologic follow-up with FTA-abs or MHA-TP found seroreversion in 9% and 5% of cases, respectively. No association between HIV-seropositivity and treponemal specific test seroreversion was demonstrated (Augenbraun et al, 1998). Castro et al performed a study of serologic follow-up of small number of patients with early syphilis.…”

Sífilis e infección por el virus de la inmunodeficiencia humana

“…En los pacientes coinfectados con el VIH hay una serie de particularidades en cuanto a la serología de la sífilis 5 . En primer lugar, presentan serología negativa durante la sífilis primaria y secundaria más frecuentemente que en la población general 43 . En segundo lugar, la tasa de falsos negativos de las pruebas reagínicas por el efecto prozona es superior 44 .…”