Using standard serology blood tests to diagnose latent syphilis

Cover Page

Abstract


Goal. To conduct a comparative assessment of the results of regulated serological tests obtained as a result of blood tests in patients suffering from latent syphilis. Materials and methods. The authors examined 187 patient medical records with newly diagnosed latent syphilis in FGBU GNTsDK (State Research Center for Dermatology, Venereology and Cosmetology), Health Ministry of the Russian Federation, in 2006-2015. The results of patient blood tests were analyzed with the use of non-treponemal (microprecipitation test/RPR) and treponemal (passive hemagglutination test, immune-enzyme assay (IgA, IgM, IgG), IFabs, immunofluorescence test and Treponema pallidum immobilization test) serology tests. Results. According to the results of blood tests of latent syphilis patients, the largest number of positive results was obtained as a result of treponemal serology tests such as immune-enzyme assay (100%), passive hemagglutination test (100%) and IFabs (100%). The greatest number of negative results was observed in non-treponemal (microprecipitation test/RPR) serology tests: in 136 (72.7%) patients; evidently positive results (4+) test results were obtained in 8 (4.3%) patients only. According to the results of a comparative analysis of blood tests in patients suffering from latent syphilis obtained with the use of treponemal serology tests, the greatest number of evidently positive results (4+) was noted for the passive hemagglutination test (67.9%). Negative treponemal test results were obtained with the use of the immunofluorescence test and Treponema pallidum immobilization test (21.9% and 11.8% of cases, respectively). Moreover, weakly positive results prevailed for the immunofluorescence test: in 65 (34.7%) patients. Conclusion. These data confirm that the following treponemal tests belong to the most reliable ones for revealing patients suffering from latent syphilis: immune-enzyme assay, passive hemagglutination test and IFabs.

About the authors

G. L. Katunin

State Research Center of Dermatovenereology and Cosmetology, Ministry of Healthcare of the Russian Federation

Author for correspondence.
Email: g.katunin@rambler.ru

Russian Federation

A. B. Rubtsov

State Research Center of Dermatovenereology and Cosmetology, Ministry of Healthcare of the Russian Federation

Email: noemail@neicon.ru

Russian Federation

References

  1. Кубанова А.А., Кубанов А.А., мелехина Л.Е., Богданова Е.В. Заболеваемость сифилисом в Российской Федерации в 2010-2014 гг. Вестн дерматол венерол 2015; 5: 15-23
  2. Приказ минздрава РФ № 87 от 26.03.2001 г. «О совершенствовании серологической диагностики сифилиса». Приложение № 1 «Постановка отборочных и диагностических тестов на сифилис»
  3. Сазонова Л.В. Лабораторная диагностика сифилиса. В рук-ве: Шапошников О.К. (ред) Венерические болезни. м: медицина 1991; 246-266
  4. Дмитриев Г.А. Лабораторная диагностика сифилиса. Сифилис: феномен, эволюция, новации. м: Бином 2010; 127-207
  5. Ballard R., Hook III EW. Syphilis. In: Laboratory diagnosis of sexually transmitted infections, in cluding human immunodeficiency virus. World Health Organization (WHO). 2013.
  6. Федеральные клинические рекомендации по ведению больных сифилисом. м, 2015. 45
  7. Pope V. Use of treponemal tests to screen for syphilis. Infect Med 2004; 21:399-402.
  8. CDC. Syphilis testing algorithms using treponemal tests for initial screening--four laboratories, New York City, 2005-2006. MMWR 2008; 57: 872-5.
  9. Sena AC., White B., Sparling PF. Novel Treponema pallidum serologic tests:a paradigm shift in syphilis screening for the 21st century. Clin Infect Dis 2010; 51: 700-8.
  10. CDC 2011. Discordant results from reverse sequence syphilis screening-five laboratories, United States, 2006-2010. MMWR Morb. Mortal. Wkly. Rep. 60: 133-137.
  11. Park I.U., Chow J.M., Bolan G., Stanley M., Shieh J., Schapiro J.M. Screening for syphilis with the treponemal immunoassay: analysis of discordant serology results and implications for clinical management. J Infect Dis 2011; 204: 1297-304.
  12. Mishra S., Boily M.C., Ng V., Gold W.L., Okura T., Shaw M., Mazzulli T., Fisman D.N. The laboratory impact of changing syphilis screening from the rapid-plasma reagin to a treponemal enzyme immunoassay: a casestudy from the Greater Toronto Area. Sex Transm Dis 2011 Mar; 38 (3): 190-6.
  13. Lipinsky D., Schreiber L., Kopel V., Shainberg B. Validation of Reverse Sequence Screening for Syphilis. J Clin Microbiol 2012 Apr; 50 (4): 1501.
  14. Binnicker M.J., Jespersen D.J., Rollins L.O. Direct Comparison of the traditional and reverse syphilis screening algorithms in a population with a low prevalence of syphilis. J Clin Microbiol, 2012; 50 (1): 148-150.
  15. Loeffelholz M.J., Binnicker M.J. It is time to use treponema-specific antibody screening tests for diagnosis of syphilis. J Clin Microbiol 2012 Jan; 50 (1): 2-6.
  16. Hee Jin Huh, Jae-Woo Chung, Seong Yeon Park, Seok Lae Chae. Comparison of Automated Treponemal and Nontreponemal Test Algorithms as First-Line Syphilis Screening Assays. Ann Lab Med 2016 Jan; 36 (1): 23-27.
  17. Janier M., Hegyi V., Dupin N., Unemo M., Tiplica G.S., Potocnik M., French P., Patel R. 2014 European guidelines on the management of syphilis. Journal of the European Academy of Dermatology and Venereology 2014; 28 (12): 1581-1593.
  18. Workowski K.A., Bolan G.A. Centers for Disease Control and Prevention.Sexually transmitted diseases treatment guidelines, 2015. MMWR Recomm Rep 2015 Jun 5; 64 (RR-03): 1-137.

Statistics

Views

Abstract - 457

PDF (Russian) - 392

PlumX

Dimensions


Copyright (c)



This website uses cookies

You consent to our cookies if you continue to use our website.

About Cookies