Changes in the Syphilis Rapid Plasma Reagin Titer Between Diagnosis and Treatment

Pandey, K; Fairley, CK; Chen, MY; Williamson, DA; Bradshaw, CS; Ong, JJ; Aung, ET; Chow, EPF

Author(s): Pandey, K; Fairley, CK; Chen, MY; Williamson, DA; Bradshaw, CS; Ong, JJ; Aung, ET; Chow, EPF;
Details: Publication Year 2023-03-04,Volume 76,Issue #5,Page 795-799
Journal Title: Clinical Infectious Diseases
Abstract: BACKGROUND: We compared the rapid plasma reagin (RPR) titer on the day of initial presentation with that on the day of syphilis treatment to inform clinical practice as to whether a repeated RPR test should be recommended. METHODS: We undertook a retrospective study between 1 March 2011 and 31 December 2020 at the Melbourne Sexual Health Centre in Australia among individuals who underwent syphilis serology on the day of initial presentation and the day of treatment, if the latter were within 14 days after initial presentation. We calculated the percentage of individuals with a ≥4-fold change in RPR titer, stratified by the time between initial presentation and treatment and by syphilis stage. RESULTS: Among the 766 included syphilis cases, the median duration between initial presentation and treatment was 6 days (interquartile range, 5-7 days). Of these cases, 14.8% (n = 113) had a ≥4-fold increase or decrease during this interval. The number of cases with a ≥4-fold increase or decrease in RPR titer increased with increasing time between initial presentation and treatment, from 5.7% (n = 6) 1-3 days after initial presentation to 26.2% (n = 27) at 10-14 days (Ptrend < .001). There was no significant difference in the number of cases with a ≥4-fold increase or decrease in RPR titer between syphilis stages (P = .66). CONCLUSIONS: Our data support the recommendation of repeating the RPR titer if the day of initial presentation and the day of treatment are different, even when treatment is within a few days after initial presentation.
Publisher: Oxford Academic
Keywords: Humans; Syphilis/diagnosis/drug therapy; Treponema pallidum; Reagins; Retrospective Studies; Syphilis Serodiagnosis
Research Division(s): Infectious Diseases And Immune Defence
PubMed ID: 36285535
Publisher's Version: https://doi.org/10.1093/cid/ciac843
Open Access at Publisher's Site: https://doi.org/10.1093/cid/ciac843
Terms of Use/Rights Notice: Refer to copyright notice on published article.
Documents: ciac843.pdf - (0.34MB, application/pdf)

Creation Date: 2023-03-29 08:34:07

Last Modified: 2023-03-29 08:58:28