Syphilis screening
Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]
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Overview
Syphilis screening tests, such as the rapid plasma reagin (RPR) and Venereal Disease Research Laboratory (VDRL) tests are cheap and fast but not completely specific, as many other conditions can cause a positive result.
Screening
Screening guidelines for syphilis are:
Non pregnant adults and adolescents (Age 15-65)
- All individuals who are at increased risk for syphilis should be screened for syphilis (A recommendation).[1][2]
- Routine screening of adolescents who are asymptomatic for syphilis is not recommended
Pregnant women
Men who have sex with men
- Anually for sexually active MSM[3]
- Every 3 to 6 months if increased risk
Persons with HIV
- At first HIV evaluation for sexually active individuals[3][5][6]
- Annually after first evaluation
- More frequent testing for individuals who are at increased risk or are residing in highly prevalent area for syphilis
- Syphilis screening tests, such as the rapid plasma reagin (RPR) and Venereal Disease Research Laboratory (VDRL) tests are cheap and fast but not completely specific, as many other conditions can cause a positive result.
- These tests are routinely used to screen blood donors. Notably, the spirochete that causes syphilis does not survive the conditions used to store blood and the number of transfusion transmitted cases of syphilis is minuscule, but the test is used to identify donors that might have contracted HIV from high risk sexual activity.
- The requirement to test for syphilis has been challenged due to the vast improvements in HIV testing.
- False positives on the rapid tests can be seen in viral infections (Epstein-Barr, hepatitis, varicella, measles), lymphoma, tuberculosis, malaria, endocarditis, connective tissue disease, pregnancy, intravenous drug abuse, or contamination. As a result, these two screening tests should always be followed up by a more specific treponemal test.
US Preventive Services Task Force (USPSTF) Recommendation [7]
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Grade A recommendation1. Screen all pregnant women for syphilis infection. |
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References
- ↑ US Preventive Services Task Force (USPSTF). Bibbins-Domingo K, Grossman DC, Curry SJ, Davidson KW, Epling JW; et al. (2016). "Screening for Syphilis Infection in Nonpregnant Adults and Adolescents: US Preventive Services Task Force Recommendation Statement". JAMA. 315 (21): 2321–7. doi:10.1001/jama.2016.5824. PMID 27272583.
- ↑ https://www.uspreventiveservicestaskforce.org/Page/Document/UpdateSummaryFinal/syphilis-infection-in-nonpregnant-adults-and-adolescents?ds=1&s=syphilis Accessed on September 19, 2016
- ↑ 3.0 3.1 3.2 http://www.cdc.gov/std/tg2015/screening-recommendations.htm#modalIdString_CDCTable_2 Accessed on September 19, 2016
- ↑ https://www.uspreventiveservicestaskforce.org/Page/Document/UpdateSummaryFinal/syphilis-infection-in-pregnancy-screening?ds=1&s=syphilis Accessed on September 19, 2016
- ↑ More, Read. "Guidelines and recommendations." (1999).
- ↑ http://hivprevent.thelancet.com/content/guidelines-and-recommendations Accesed on September 19, 2016
- ↑ "National Guideline Clearinghouse | Screening for syphilis infection in pregnancy: U.S. Preventive Services Task Force reaffirmation recommendation statement". Retrieved 2012-12-18.