Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
. 2012 Jul;33(2):102-6.
doi: 10.4103/0253-7184.102117.

Evaluation of the usefulness of Treponema pallidum hemagglutination test in the diagnosis of syphilis in weak reactive Venereal Disease Research Laboratory sera

Manju Bala  1 , Aman Toor, Meenakshi Malhotra, Monika Kakran, Sumathi Muralidhar, V Ramesh
Affiliations

Evaluation of the usefulness of Treponema pallidum hemagglutination test in the diagnosis of syphilis in weak reactive Venereal Disease Research Laboratory sera

Manju Bala et al. Indian J Sex Transm Dis AIDS. 2012 Jul.

Abstract

Background and objectives: Biological false positive (BFP) reactivity by the Venereal Disease Research Laboratory (VDRL) test used for diagnosis of syphilis is a cause for concern. The use of the VDRL as a screening procedure is challenged by some studies. The aim of this study is to determine the prevalence of BFP reactions in different subject groups and to assess the usefulness of Treponema pallidum hemagglutination (TPHA) test in low titre VDRL reactive sera.

Materials and methods: A total of 5785 sera from sexually transmitted diseases (STD) clinic attendees, antenatal clinic attendees, husbands of antenatal cases, peripheral health centres attendees (representing community population) and from patients referred from different OPDs/wards were screened for BFP reactions by the VDRL test. Sera reactive in the VDRL test were confirmed by the TPHA test.

Results: Out of 80 qualitative VDRL reactive sera, 68 had <1:8 titre on quantitation and TPHA was positive in 59 samples, indicating BFP reactivity in 0.2% in all the subject groups. BFP was nil in the community population. The male-to-female ratio of BFP reactions was 2:1. VDRL and TPHA positivity was highest (76%) in the age group of 20-29 years. The seroprevalence of syphilis varied from 0.4% to 3.5% in different patient groups.

Conclusions: The results of this study highlight that the TPHA positivity was high (86.8%) in sera with VDRL titre less than 1:8. Therefore, for the diagnosis of syphilis, it is recommended that a confirmatory test such as TPHA should be performed on all sera with a reactive VDRL regardless of its titre.

Keywords: Biological false positive; Syphilis; Treponema pallidum hemagglutination; Venereal disease research laboratory.

PubMed Disclaimer

Conflict of interest statement

Conflict of Interest: None declared.

Similar articles

See all similar articles

Cited by

See all "Cited by" articles

References

    1. World Health Organization. Geneva: WHO; 1982. Treponemal infections.Technical reports series 674.
    1. Luger AF. Immunological diagnosis of sexually transmitted diseases. In: Young H, McMillan A, editors. Serological diagnosis of syphilis: current methods. New York: Marcel Decker; 1988. pp. 249–74.
    1. Smikle MF, James OB, Prabhakar P. Biological false positive serological tests for syphilis in the Jamaican population. Genitourin Med. 1990;66:76–8. - PMC - PubMed
    1. Geusau A, Kittler H, Hein U, Dangl-Erlach E, Stingl G, Tschachler E. Biological false-positive tests comprise a high proportion of Venereal Disease Research Laboratory reactions in an analysis of 300,000 sera. Int J STD AIDS. 2005;16:722–6. - PubMed
    1. Hossain A. Serological tests for syphilis in Saudi Arabia. Genitourin Med. 1986;62:293–7. - PMC - PubMed