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[Preprint]. 2025 Nov 9:2025.11.07.25339586.
doi: 10.1101/2025.11.07.25339586.

Estimating the sensitivity of non-treponemal and treponemal antibody tests in primary syphilis

Stephanie F Sweitzer, Jane S Chen, Mitch M Matoga, Ligang Yang, Eduardo Lopez-Medina, Jonny A Garcia-Luna, Irving F Hoffman, Bin Yang, Juan C Salazar, Justin D Radolf, Jonathan B Parr, Arlene C Seña

Estimating the sensitivity of non-treponemal and treponemal antibody tests in primary syphilis

Stephanie F Sweitzer et al. medRxiv. .

Abstract

Among patients with primary syphilis, sensitivity of TRUST was 55% (6/11) compared to darkfield microscopy (DFM) and 60% (9/15) compared to Treponema pallidum PCR. Sensitivity of RPR was 78% (38/49) and 93% (43/46), respectively. TPPA had a sensitivity of 95% (41/43) compared to DFM and 96% (43/45) compared to PCR.

Short summary: Compared to direct detection methods for the diagnosis of primary syphilis, TRUST has low sensitivity, RPR has moderate to good sensitivity, and TPPA has high sensitivity.

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