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Seronegative and Low Seropositive Treatment-Naive Secondary Syphilis in India: A Cross Sectional Study
The non-treponemal tests like VDRL and RPR hold an important place in the diagnosis of syphilis. In many countries, these tests are used for screening, with positive results being subsequently confirmed by treponemal or specific tests like TPHA or FTA-ABS. Recent observations of low-titer VDRL or RP...
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| Published in: | Indian Journal of Dermatology 2024, Vol.69 (6), p.486 |
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| Main Authors: | , , |
| Format: | Report |
| Language: | English |
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| container_issue | 6 |
| container_start_page | 486 |
| container_title | Indian Journal of Dermatology |
| container_volume | 69 |
| creator | Ghosh, Aparajita Panda, Saumya Bhattacharyya, Surjyamukhi |
| description | The non-treponemal tests like VDRL and RPR hold an important place in the diagnosis of syphilis. In many countries, these tests are used for screening, with positive results being subsequently confirmed by treponemal or specific tests like TPHA or FTA-ABS. Recent observations of low-titer VDRL or RPR positivity ( |
| doi_str_mv | 10.4103/ijd.ijd_338_24 |
| format | report |
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In many countries, these tests are used for screening, with positive results being subsequently confirmed by treponemal or specific tests like TPHA or FTA-ABS. Recent observations of low-titer VDRL or RPR positivity (<1:8) or negative results in patients with clinically active syphilis are becoming a cause for concern especially in the backdrop of a resurgence of the disease. Such a scenario might undermine the usefulness of VDRL or RPR as effective screening test and for treatment monitoring. We studied the titers of non-treponemal serological test (VDRL) in non-HIV-positive, untreated cases of secondary syphilis (diagnosed clinically and confirmed serologically with specific treponemal tests like TPHA or FTA-ABS). It was an OPD-based cross-sectional study, which included patients presenting with muco-cutaneous lesions suggestive of secondary syphilis, confirmed serologically with positive specific treponemal tests, who were seronegative for HIV1 and 2 and had not received treatment with injectable benzathine penicillin. Their VDRL titers were noted. Information regarding duration of lesions and any previous genital ulcer was obtained, and additional information was sought regarding any medications taken during the last two months. Nineteen patients (12 males, 4 females, and 3 transgender individuals) between the ages of 18 and 46 years were included in the study. Ten of these cases (52.63) had a VDRL titer of less than 1:8 (non-reactive in 5 patients, titer of 1:4 in 5 patients). Among the remaining nine cases, a titer of 1:8 was observed in six, 1: 16 in two, and 1:32 in one case. Our observations raise concerns regarding the possibility that a significant number of patients with active syphilis and potential to transmit the disease are being left untreated because of low or negative titers in the screening tests. This may account for the slow resurgence of syphilis as documented by increase in case rates and incidence of congenital syphilis in different parts of the world.</description><identifier>ISSN: 0019-5154</identifier><identifier>DOI: 10.4103/ijd.ijd_338_24</identifier><language>eng</language><publisher>Medknow Publications and Media Pvt. Ltd</publisher><subject>Diagnosis ; Disease transmission ; Drug therapy ; Medical research ; Medical screening ; Medicine, Experimental ; Metronidazole ; Syphilis</subject><ispartof>Indian Journal of Dermatology, 2024, Vol.69 (6), p.486</ispartof><rights>COPYRIGHT 2024 Medknow Publications and Media Pvt. 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Recent observations of low-titer VDRL or RPR positivity (<1:8) or negative results in patients with clinically active syphilis are becoming a cause for concern especially in the backdrop of a resurgence of the disease. Such a scenario might undermine the usefulness of VDRL or RPR as effective screening test and for treatment monitoring. We studied the titers of non-treponemal serological test (VDRL) in non-HIV-positive, untreated cases of secondary syphilis (diagnosed clinically and confirmed serologically with specific treponemal tests like TPHA or FTA-ABS). It was an OPD-based cross-sectional study, which included patients presenting with muco-cutaneous lesions suggestive of secondary syphilis, confirmed serologically with positive specific treponemal tests, who were seronegative for HIV1 and 2 and had not received treatment with injectable benzathine penicillin. Their VDRL titers were noted. Information regarding duration of lesions and any previous genital ulcer was obtained, and additional information was sought regarding any medications taken during the last two months. Nineteen patients (12 males, 4 females, and 3 transgender individuals) between the ages of 18 and 46 years were included in the study. Ten of these cases (52.63) had a VDRL titer of less than 1:8 (non-reactive in 5 patients, titer of 1:4 in 5 patients). Among the remaining nine cases, a titer of 1:8 was observed in six, 1: 16 in two, and 1:32 in one case. Our observations raise concerns regarding the possibility that a significant number of patients with active syphilis and potential to transmit the disease are being left untreated because of low or negative titers in the screening tests. This may account for the slow resurgence of syphilis as documented by increase in case rates and incidence of congenital syphilis in different parts of the world.</description><subject>Diagnosis</subject><subject>Disease transmission</subject><subject>Drug therapy</subject><subject>Medical research</subject><subject>Medical screening</subject><subject>Medicine, Experimental</subject><subject>Metronidazole</subject><subject>Syphilis</subject><issn>0019-5154</issn><fulltext>true</fulltext><rsrctype>report</rsrctype><creationdate>2024</creationdate><recordtype>report</recordtype><sourceid/><recordid>eNqVjs1qwzAQhHVooenPted9ASdSZVO3txAaEii9OHezRGt3g7oKkpLit68d8gI9DMN8fIdR6tnoeWm0XfDBzce01tbtS3mjZlqbt6IyVXmn7lM6aF1aU5uZ6hqKQajHzGcCFAef4RcmeAyJL3AXCfMPSS6-cNoN7YM4jAM0w_GbPSdgga04xndYwiqGlCYpcxD00OSTGx7VbYc-0dO1H1Sx_titNkWPnlqWLuSI-56EIvrxT8cjXtamMq_jzdr-1_8DIhdT8w</recordid><startdate>20241101</startdate><enddate>20241101</enddate><creator>Ghosh, Aparajita</creator><creator>Panda, Saumya</creator><creator>Bhattacharyya, Surjyamukhi</creator><general>Medknow Publications and Media Pvt. Ltd</general><scope/></search><sort><creationdate>20241101</creationdate><title>Seronegative and Low Seropositive Treatment-Naive Secondary Syphilis in India: A Cross Sectional Study</title><author>Ghosh, Aparajita ; Panda, Saumya ; Bhattacharyya, Surjyamukhi</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-gale_infotracgeneralonefile_A8151718183</frbrgroupid><rsrctype>reports</rsrctype><prefilter>reports</prefilter><language>eng</language><creationdate>2024</creationdate><topic>Diagnosis</topic><topic>Disease transmission</topic><topic>Drug therapy</topic><topic>Medical research</topic><topic>Medical screening</topic><topic>Medicine, Experimental</topic><topic>Metronidazole</topic><topic>Syphilis</topic><toplevel>online_resources</toplevel><creatorcontrib>Ghosh, Aparajita</creatorcontrib><creatorcontrib>Panda, Saumya</creatorcontrib><creatorcontrib>Bhattacharyya, Surjyamukhi</creatorcontrib></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Ghosh, Aparajita</au><au>Panda, Saumya</au><au>Bhattacharyya, Surjyamukhi</au><format>book</format><genre>unknown</genre><ristype>RPRT</ristype><atitle>Seronegative and Low Seropositive Treatment-Naive Secondary Syphilis in India: A Cross Sectional Study</atitle><jtitle>Indian Journal of Dermatology</jtitle><date>2024-11-01</date><risdate>2024</risdate><volume>69</volume><issue>6</issue><spage>486</spage><pages>486-</pages><issn>0019-5154</issn><abstract>The non-treponemal tests like VDRL and RPR hold an important place in the diagnosis of syphilis. In many countries, these tests are used for screening, with positive results being subsequently confirmed by treponemal or specific tests like TPHA or FTA-ABS. Recent observations of low-titer VDRL or RPR positivity (<1:8) or negative results in patients with clinically active syphilis are becoming a cause for concern especially in the backdrop of a resurgence of the disease. Such a scenario might undermine the usefulness of VDRL or RPR as effective screening test and for treatment monitoring. We studied the titers of non-treponemal serological test (VDRL) in non-HIV-positive, untreated cases of secondary syphilis (diagnosed clinically and confirmed serologically with specific treponemal tests like TPHA or FTA-ABS). It was an OPD-based cross-sectional study, which included patients presenting with muco-cutaneous lesions suggestive of secondary syphilis, confirmed serologically with positive specific treponemal tests, who were seronegative for HIV1 and 2 and had not received treatment with injectable benzathine penicillin. Their VDRL titers were noted. Information regarding duration of lesions and any previous genital ulcer was obtained, and additional information was sought regarding any medications taken during the last two months. Nineteen patients (12 males, 4 females, and 3 transgender individuals) between the ages of 18 and 46 years were included in the study. Ten of these cases (52.63) had a VDRL titer of less than 1:8 (non-reactive in 5 patients, titer of 1:4 in 5 patients). Among the remaining nine cases, a titer of 1:8 was observed in six, 1: 16 in two, and 1:32 in one case. Our observations raise concerns regarding the possibility that a significant number of patients with active syphilis and potential to transmit the disease are being left untreated because of low or negative titers in the screening tests. This may account for the slow resurgence of syphilis as documented by increase in case rates and incidence of congenital syphilis in different parts of the world.</abstract><pub>Medknow Publications and Media Pvt. Ltd</pub><doi>10.4103/ijd.ijd_338_24</doi></addata></record> |
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| identifier | ISSN: 0019-5154 |
| ispartof | Indian Journal of Dermatology, 2024, Vol.69 (6), p.486 |
| issn | 0019-5154 |
| language | eng |
| recordid | cdi_gale_infotracgeneralonefile_A815171818 |
| source | NCBI_PubMed Central（免费）; Directory of Open Access Journals |
| subjects | Diagnosis Disease transmission Drug therapy Medical research Medical screening Medicine, Experimental Metronidazole Syphilis |
| title | Seronegative and Low Seropositive Treatment-Naive Secondary Syphilis in India: A Cross Sectional Study |
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