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. 1992 Jan;45(1):37–41. doi: 10.1136/jcp.45.1.37

Enzyme immunoassay for anti-treponemal IgG: screening or confirmatory test?

H Young 1, A Moyes 1, A McMillan 1, J Patterson 1
PMCID: PMC495810  PMID: 1740512

Abstract

AIMS: To review the performance of the Venereal Diseases Research Laboratory (VDRL) test and the Treponema pallidum haemagglutination assay (TPHA) as a combined screen for syphilis to provide a baseline for assessing screening by anti-treponemal IGG EIA. METHODS: Between 1980 and 1987 all serum samples were screened by both VDRL and TPHA tests. The FTA-ABS test was also used in suspected early primary syphilis, or when one of the other tests was positive. A positive result in a screening test was confirmed by quantitative testing. From 1988 all specimens were screened with an enzyme immunoassay (Captia Syph G) as a single screening test. RESULTS: Of the 44 primary, 47 secondary, and 38 early latent cases of syphilis, the VDRL and TPHA detected 32 (73%) and 31 (71%) of the primary cases; the combination detected 37 (84%). All 85 cases of cases of secondary and early latent infection were reactive in the TPHA test, whereas the VDRL was reactive in only 68 (80%). EIA had a reported sensitivity of 82% for primary infection. CONCLUSIONS: EIA can be used as a single screening test for detecting early syphilis because its results are comparable with those of the combined VDRL and TPHA tests. The conventional VDRL test should not be used as a single screening test.

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Selected References

These references are in PubMed. This may not be the complete list of references from this article.

  1. Anderson J., Mindel A., Tovey S. J., Williams P. Primary and secondary syphilis, 20 years' experience. 3: Diagnosis, treatment, and follow up. Genitourin Med. 1989 Aug;65(4):239–243. doi: 10.1136/sti.65.4.239. [DOI] [PMC free article] [PubMed] [Google Scholar]
  2. Baker-Zander S. A., Hook E. W., 3rd, Bonin P., Handsfield H. H., Lukehart S. A. Antigens of Treponema pallidum recognized by IgG and IgM antibodies during syphilis in humans. J Infect Dis. 1985 Feb;151(2):264–272. doi: 10.1093/infdis/151.2.264. [DOI] [PubMed] [Google Scholar]
  3. Berkowitz K., Baxi L., Fox H. E. False-negative syphilis screening: the prozone phenomenon, nonimmune hydrops, and diagnosis of syphilis during pregnancy. Am J Obstet Gynecol. 1990 Sep;163(3):975–977. doi: 10.1016/0002-9378(90)91107-n. [DOI] [PubMed] [Google Scholar]
  4. Farshy C. E., Hunter E. F., Larsen S. A., Cerny E. H. Double-conjugate enzyme-linked immunosorbent assay for immunoglobulins G and M against Treponema pallidum. J Clin Microbiol. 1984 Dec;20(6):1109–1113. doi: 10.1128/jcm.20.6.1109-1113.1984. [DOI] [PMC free article] [PubMed] [Google Scholar]
  5. Feraru E. R., Aronow H. A., Lipton R. B. Neurosyphilis in AIDS patients: initial CSF VDRL may be negative. Neurology. 1990 Mar;40(3 Pt 1):541–543. doi: 10.1212/wnl.40.3_part_1.541. [DOI] [PubMed] [Google Scholar]
  6. Garland S. M., Kelly V. N. Is antenatal screening for syphilis worth while? Med J Aust. 1989 Oct 2;151(7):368–372. [PubMed] [Google Scholar]
  7. Gilbert G. L. Congenital syphilis--should we worry? Med J Aust. 1988 Feb 15;148(4):162–164. [PubMed] [Google Scholar]
  8. Hicks C. B., Benson P. M., Lupton G. P., Tramont E. C. Seronegative secondary syphilis in a patient infected with the human immunodeficiency virus (HIV) with Kaposi sarcoma. A diagnostic dilemma. Ann Intern Med. 1987 Oct;107(4):492–495. doi: 10.7326/0003-4819-107-4-492. [DOI] [PubMed] [Google Scholar]
  9. Rufli T. Syphilis and HIV infection. Dermatologica. 1989;179(3):113–117. doi: 10.1159/000248335. [DOI] [PubMed] [Google Scholar]
  10. SPANGLER A. S., JACKSON J. H., FIUMARA N. J., WARTHIN T. A. SYPHILIS WITH A NEGATIVE BLOOD TEST REACTION. JAMA. 1964 Jul 13;189:87–90. doi: 10.1001/jama.1964.03070020015003. [DOI] [PubMed] [Google Scholar]
  11. Stevens R. W., Schmitt M. E. Evaluation of an enzyme-linked immunosorbent assay for treponemal antibody. J Clin Microbiol. 1985 Mar;21(3):399–402. doi: 10.1128/jcm.21.3.399-402.1985. [DOI] [PMC free article] [PubMed] [Google Scholar]
  12. Tang A., Barlow D. Resurgence of heterosexually acquired early syphilis in London. Lancet. 1989 Jul 15;2(8655):166–167. doi: 10.1016/s0140-6736(89)90232-8. [DOI] [PubMed] [Google Scholar]
  13. Veldkamp J., Visser A. M. Application of the enzyme-linked immunosorbent assay (ELISA) in the serodiagnosis of syphilis. Br J Vener Dis. 1975 Aug;51(4):227–231. doi: 10.1136/sti.51.4.227. [DOI] [PMC free article] [PubMed] [Google Scholar]
  14. Young H., Henrichsen C., Robertson D. H. Treponema pallidum haemagglutination test as a screening procedure for the diagnosis of syphilis. Br J Vener Dis. 1974 Oct;50(5):341–346. doi: 10.1136/sti.50.5.341. [DOI] [PMC free article] [PubMed] [Google Scholar]
  15. Young H., Moyes A., McMillan A., Robertson D. H. Screening for treponemal infection by a new enzyme immunoassay. Genitourin Med. 1989 Apr;65(2):72–78. doi: 10.1136/sti.65.2.72. [DOI] [PMC free article] [PubMed] [Google Scholar]
  16. van den Hoek J. A., van der Linden M. M., Coutinho R. A. Increase of infectious syphilis among heterosexuals in Amsterdam: its relationship to drug use and prostitution. Genitourin Med. 1990 Feb;66(1):31–32. doi: 10.1136/sti.66.1.31. [DOI] [PMC free article] [PubMed] [Google Scholar]

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