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Nontreponemal tests are an indirect method in that they detect biomarkers that are released during cellular damage that occurs from the syphilis spirochete. In contrast, treponemal tests look for antibodies that are a direct result of the infection thus, anti-treponeme IgG, IgM and to a lesser degree IgA.
The Venereal Disease Research Laboratory test (VDRL) is a blood test for syphilis and related non-venereal treponematoses that was developed by the eponymous US laboratory. The VDRL test is used to screen for syphilis (it has high sensitivity), whereas other, more specific tests are used to diagnose the disease.
The rapid plasma reagin test (RPR test or RPR titer) is a type of rapid diagnostic test that looks for non-specific antibodies in the blood of the patient that may indicate an infection by syphilis or related non-venereal treponematoses. It is one of several nontreponemal tests for syphilis (along with the Wassermann test and the VDRL test).
Syphilis (/ ˈ s ɪ f ə l ɪ s /) is a sexually transmitted infection caused by the bacterium Treponema pallidum subspecies pallidum. [1] The signs and symptoms depend on the stage it presents: primary, secondary, latent or tertiary.
The Wassermann test or Wassermann reaction (WR) [1] is an antibody test for syphilis, named after the bacteriologist August Paul von Wassermann, based on complement fixation. It was the first blood test for syphilis and the first in the nontreponemal test (NTT) category. Newer NTTs, such as the RPR and VDRL tests, have mostly replaced it.
Please note the image (Fig 1) of the wells on the test plate and the positive and negative test results look different. [1] For primary syphilis, TPPA has a sensitivity of 85% to 100%, and a specificity of 98% to 100%. [2] In secondary and late-latent syphilis, TPPA has a sensitivity of 98% to 100%. [2]
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A non-reactive (negative) rapid point of care test should still be followed up with immunoassay testing such as by a fourth-generation test after the window period. [27] Similarly, individuals taking pre-exposure prophylaxis (PrEP) can experience extended window periods compared to the average population, leading to ambiguous testing. [ 28 ]