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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