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Re: biologic false positives for RPR and FTA-ABSFrom: Betsy Hyde (elishyde@connix.com)Tue Feb 22 21:50:37 2000
http://www.ohd.hr.state.or.us/phl/vi/syph.htm discusses biological false positives for RPR/VDRL and FTA-ABS tests the following discusses false positive FTA-ABS with HIV infection: SYPHILIS SEROLOGY IN HIV INFECTION: EVIDENCE FOR FALSE-POSITIVE FLUORESCENT TREPONEMAL TESTING Horváth I., Nagy K., Várkonyi V., +Scythes J., +Notenboom W., Horváth A. Nat.Inst.of Derm.Ven.Budapest,Hungary, +Phoenix Diagnostics, Toronto, Ca. Objectives: HIV infected persons were assessed serologically for syphilis (sy) every 6 months. The specific reactions were accepted as verification for sy. The evidence of false-negative specific tests is also known but the false-positive specific reaction in the connection of HIV has not been published. The authors studied the HIV positive sera in persons with and without a history of sy, using different tests. Methods: HIV positive sera (n, f/m -7/74, Age 42 ± 22) were tested for syphilis with: RPR, 3 different TPHAs, FTA-ABS and Western blot technic for IgG and IgM on several randomly selected sera. The results were evaluated on the basis of (i) anamnestic data of sy infection and (ii) the progression of HIV disease according to CDC classification. Results: 44 of the sera were negative in all tests. 7 sera were reactive in all tests. 13 sera were reactive in all specific tests. 16 sera were reactive in only FTA-ABS test. 1 sera was reactive only in Fujirebio TPHA. Only 4 sera of the 16 FTA-ABS reactive had sy anamnestic background. 10 of the FTA-ABS only reactives were controlled by Western blot for IgG and IgM, 4 of these had a sy background, 6 of them not. Each of these 10 were negative in the Western blot. The authors conclude that the specific tests could be either reactive or non-reactive independent of the patient's sy history. Conclusion: The role of cofactor disease in susceptibility to HIV infection/activation has yet to be determined. In view of these problems with the accepted sy diagnostic tests it is difficult to determine the precise role of T. pallidum. Better detection techniques, such as PCR and RIT for verification of negative results on standard serologic tests, are probably necessary in those persons with HIV in increased STD risk. Abstract P46, presented at the International Union Against Sexually Transmitted Infections (IUSTI) European Congress 1998 on STDs and Genital Dermatology, Göteborg, Sweden, 4-5 September, 1998
-- Betsy Hyde CNM Branford, CT
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