II. Indications: Syphilis Testing
- Rapid Treponemal Immunoassays
- Reverse sequence Syphilis Screening (first step)
- Confirmed with a Non-Treponemal Test such as RPR or VDRL (and the manual TP-PA if needed for discrepancy)
- Manual Treponemal Assays
- Confirmation of positive Non-Treponemal Test in standard sequence testing OR
- Confirmation in reverse sequence testing with positive rapid immunoassay, but negative RPR/VDRL
III. Mechanism
- Treponemal Antigen precipitates Antibody
- Treponemal Test (using specific Treponemal Antigen)
- Contrast with Non-Treponemal Tests (e.g. RPR or VDRL) using cardiolipin/lecithin extract from beef heart
- Confirm positive with MHA-TP (See Syphilis Serology)
IV. Labs: Rapid Treponemal Immunoassays
- Indications
- Rapid Immunoassays are used as a first step in reverse sequence Syphilis Screening (see Syphilis Testing)
- Automated processing and high Test Sensitivity allows for cost effective sample processing
- Confirmed with a Non-Treponemal Test such as RPR or VDRL (reverse sequence)
- Discrepant tests (positive immunoassay, negative RPR/VDRL) is confirmed with Manual Assay (e.g. TP-PA)
- Methadologies (dozens of available immunoassays)
- Enzyme immunoassay (EIA)
- Chemiluminescence immunoassays (CIA)
- Microbead Immunoassays (MBIA)
- Composite Immunoassay efficacy
- Test Specificity >94% (except 83% for TrepSure)
- Test Sensitivity: 94 to 100%
- Primary Syphilis: >94% (most assays)
- Secondary Syphilis: 100%
- Early Latent Syphilis: 95% to 100%
- Late Latent Syphilis: 92% to 100%
V. Labs: Manual Treponemal Assays
- Background
- High Test Specificity and sensitivity allows for definitive confirmatory testing (esp. TP-PA)
- Indications
- Confirmation of positive Non-Treponemal Test in standard sequence testing OR
- Confirmation in reverse sequence testing with positive rapid immunoassay, but negative RPR/VDRL
- Treponema Pallidum Particle Agglutination Assay (TP-PA)
- Highest efficacy of the Manual Treponemal Assays
- Test Specificity: 99%
- Test Sensitivity
- Primary Syphilis: 86 to 100%
- Secondary Syphilis: 100%
- Early Latent Syphilis: 94 to 100%
- Late Latent Syphilis: 87 to 100%
- Fluorescent Treponemal Antibody (FTA-ABS)
- Test Specificity: 87-100%
- Test Sensitivity
- Primary Syphilis: 78 to 100%
- Secondary Syphilis: 93 to 100%
- Early Latent Syphilis: 94 to 100%
- Late Latent Syphilis: 84 to 93%
- Microhemagglutination - Treponema pallidum (MHA-TP)
- Test Specificity: 99%
- Test Sensitivity
- Primary Syphilis: 46 to 89%
- Secondary Syphilis: 90 to 100%
- Early Latent Syphilis: 94 to 100%
- Late Latent Syphilis: 97%
VI. Causes: Negative Test (Non-reactive)
- Syphilis absent
-
False Negatives
- Early Primary Syphilis (first 2 weeks after infection)
- Late Latent Syphilis
VII. Causes: Positive Test (Reactive)
Images: Related links to external sites (from Bing)
Related Studies
| Definition (MSH) | Serologic assay that detects antibodies to Treponema pallidum, the etiologic agent of syphilis. After diluting the patient's serum to remove non-specific antibodies, the serum is mixed on a glass slide with Nichol's strain of Treponema pallidum. An antigen-antibody reaction occurs if the test is positive and the bound antibodies are detected with fluoresceinated antihuman gamma-globulin antibody. |
| Concepts | Laboratory Procedure (T059) |
| MSH | D016508 |
| SnomedCT | 165784009, 143191005, 9232009 |
| English | Fluorescent Treponemal Antibody-Absorption Test, FTA ABS Test, FTA-ABS Test, FTA-ABS Tests, Test, FTA-ABS, Tests, FTA-ABS, FTA(Abs) - Fluor trep a/b test, Fluores treponemal a/body test, Fluorescent treponemal antibody test, fta ab test, fta-abs tests, fta-abs test, Fluorescent Treponemal Antibody Absorption Test, Fluorescent treponemal antibody test (procedure), Fluorescent treponemal antibody absorption test, FTA-ABS test, FTA(Abs) - Fluorescent treponemal antibody test, Fluorescent treponemal antibody absorption test (procedure) |
| Swedish | FTA-absorption |
| Czech | Treponema pallidum - fluorescenční stanovení protilátek |
| Finnish | FTA-ABS-testi |
| French | Test FTA-ABS, Test de détection d'anticorps anti-tréponème par immunofluorescence indirecte, Test FTA-Abs |
| Russian | TREPONEMY ANTITEL FLIUORESTSENTNYI ANALIZ, ANTITEL K TREPONEME FLIUORESTSENTNYI TEST, FLIUORESTSENTNO-ABSORBTSIONNYI ANALIZ ANTITEL K TREPONEME, ANTITEL K TREPONEME ABSORBTSIONNO-FLIUORESTSENTNYI ANALIZ, АНТИТЕЛ К ТРЕПОНЕМЕ АБСОРБЦИОННО-ФЛЮОРЕСЦЕНТНЫЙ АНАЛИЗ, АНТИТЕЛ К ТРЕПОНЕМЕ ФЛЮОРЕСЦЕНТНЫЙ ТЕСТ, ТРЕПОНЕМЫ АНТИТЕЛ ФЛЮОРЕСЦЕНТНЫЙ АНАЛИЗ, ФЛЮОРЕСЦЕНТНО-АБСОРБЦИОННЫЙ АНАЛИЗ АНТИТЕЛ К ТРЕПОНЕМЕ |
| Italian | FTA-ABS Test, Test di assorbimento degli anticorpi anti Treponema in fluorescenza |
| Polish | Test absorpcyjno-fluorescencyjny przeciwciał Treponema, Test FTA-ABS |
| Japanese | FTA-ABSテスト, 梅毒トレポネーマ蛍光抗体吸収テスト |
| Norwegian | FTA-ABS-test |
| Spanish | Test de Absorción del Anticuerpo Fluorescente de Treponema, prueba FTA - ABS, prueba de absorción fluorescente de anticuerpos anti - treponémicos (procedimiento), prueba de absorción fluorescente de anticuerpos anti - treponémicos, Test FTA-ABS, Prueba de Absorción de Anticuerpos Fluorescentes de Treponema |
| German | FTA-ABS-Test, Fluoreszenz-Treponema-Antikörper-Absorptionstest |
| Dutch | FTA-ABS-test, Fluorescent-treponemal-antibody-absorptiontest, Test, fluorescent-treponemal-antibody-absorption- |
| Portuguese | Teste de Absorção do Anticorpo Treponêmico Fluorescente, Teste FTA-ABS |
Ontology: Microhemagglutination test for antibody to syphilis (C0201402)
| Concepts | Laboratory Procedure (T059) |
| SnomedCT | 51571009 |
| English | Microhemagglutination test for antibody to syphilis, Microhemagglutination test for antibody to syphilis (procedure), MHA-TP - Microhemagglutination assay for Treponema pallidum |
| Spanish | prueba de microhemaglutinación para anticuerpos treponémicos (procedimiento), prueba de microhemaglutinación para anticuerpos treponémicos |
Ontology: Treponema pallidum antibody confirmatory test (C0373943)
| Concepts | Laboratory Procedure (T059) |
| SnomedCT | 104334001 |
| English | Treponema Pallidum antibody confirmatory test, Confirmatory test for Treponema pallidum antibody, Treponema pallidum antibody confirmatory test, Treponema pallidum antibody confirmatory test (procedure), Treponema Pallidum antibody confirmatory test (procedure) |
| Spanish | prueba de confirmación de la presencia de anticuerpos anti - Treponema pallidum (procedimiento), prueba de confirmación de la presencia de anticuerpos anti - Treponema pallidum |
Ontology: Treponema pallidum particle agglutination test (C1303222)
| Concepts | Laboratory Procedure (T059) |
| SnomedCT | 401262008 |
| English | Treponema pallidum particle agglutination test (procedure), Treponema pallidum particle agglutination test |
| Spanish | prueba de partículas de aglutinación del Treponema pallidum (procedimiento), prueba de partículas de aglutinación del Treponema pallidum |
Ontology: Treponema test (C2748338)
| Concepts | Laboratory Procedure (T059) |
| English | Treponema test |
| Spanish | Prueba de Treponema |
| Portuguese | Teste de Treponema |
| French | Test Treponema |
| Dutch | Treponema-test |
| Italian | Test per Treponema |
| German | Treponema-Test |
| Czech | Test na průkaz treponema |
| Japanese | ﾄﾚﾎﾟﾈｰﾏｹﾝｻ, トレポネーマ検査 |
| Hungarian | Treponema vizsgálat |
Ontology: serum enzyme immunoassay treponema pallidum (C3835894)
| Concepts | Laboratory Procedure (T059) |
| English | serum enzyme immunoassay treponema pallidum (lab test), serum enzyme immunoassay treponema pallidum |
