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Table 1 Diagnostic tests for syphilis

From: Looking at the positives: proactive management of STIs in people with HIV

Approach

Method

Use

Features

Direct detection

Dark ground microscopy

PCR

 

Require exudates and fluids from lesions

PCR improving diagnostic thresholds

Treponemal tests

EIA

TPHA/TPPA

Western blot (IgG or IgM)

Screening

Highly sensitive

Do not correlate with disease activity

Non-treponemal tests (against anti-cardiolipin antibodies)

VDRL

RPR

Monitor treatment response

Qualitative titre

Correlate with disease activity and treatment response

Risk of false positive results

  1. EIA enzyme immunoassay, IgG immunoglobulin G, IgM immunoglobulin M, PCR polymerase chain reaction, TPHA Treponema pallidum haemagglutination assay, TPPA Treponema pallidum particle agglutination assay, RPR rapid plasma reagin, VDRL venereal disease research laboratory