Treponema Pallidum antibodies. Historically, the serologic testing algorithm for syphilis included an initial nontreponemal screening test, such as the rapid plasma reagin (RPR) or the venereal disease research laboratory (VDRL) tests. Because these tests measure the host’s antibody response to nontreponemal antigens, they lack specificity. Therefore, a positive result by RPR or VDRL requires confirmation by a treponemal-specific test, such as the fluorescent treponemal antibody-absorbed (FTA-ABS) or microhemagglutination assay (MHA-TP). Although the FTA-ABS and MHA-TP are technically simple to perform, they are labor intensive and require subjective interpretation by testing personnel. Tha is why our laboratories has decided to offer a Treponema Antibodies IFA test.
Treponema Pallidum antibodies $109.00
During early primary syphilis, the first antibodies to appear are of the IgM-class, with IgG-class antibodies reaching significant titers later in the primary phase. As the disease progresses into the secondary phase, IgG-class antibodies to Treponema pallidum reach peak titers, and may persist indefinitely regardless of the disease state or prior therapy.
For prenatal syphilis screening, the IgG test is recommended. IgM testing should not be performed during routine pregnancy screening unless clinically indicated.
Treponema pallidum IgG antibodies persist indefinitely, regardless of the course of the disease. If treatment of an original Treponema pallidum infection was not monitored, a diagnosis of reinfection may actually represent either a resurgence of an inadequately treated earlier infection or persistent IgG antibodies from a resolved infection.
A positive IgG treponemal test suggests infection withTreponema pallidum at some point in the past, but does not distinguish between treated and untreated infections. This is because treponemal tests (eg, EIA, multiplex flow immunoassay, or fluorescent treponemal antibody-absorbed) may remain reactive for life, even following adequate therapy. Therefore, the results of a nontreponemal assay, such as rapid plasma reagin, are needed to provide information on a patient’s disease state and history of therapy.
This test is not offered as a screening or confirmatory test for blood donor specimens.
Despite active syphilis, serologic tests may be negative in severely immunosuppressed patients such as those with AIDS.
In very early cases of primary syphilis, both IgM and IgG serologies may be negative.
In cases of old, successfully treated infection (>10 years earlier), both IgG and IgM serologies may be negative.