Guidance

Results table and reporting comments for syphilis

Updated 25 May 2022

Applies to England

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The table below shows different testing results. For each set of results, clinical comments for reports and recommendations for the laboratory team are outlined below the table.

Result EIA/CLIA TPPA/TPHA RPR
1 Not detected Not required Not required
2 Detected or equivocal Positive Negative: titre ≤ 1:16
3 Detected or equivocal Positive Positive: titre > 1:16
4 Detected or equivocal Negative Negative
5 Detected or equivocal (repeat sample) Negative Negative
6 Detected or equivocal Negative Positive
7 Detected or equivocal (repeat sample) Negative Positive

Result 1

For this result, the clinical comments to report are:

  • treponemal antibody not detected
  • no evidence of treponemal infection
  • repeat if at risk of recent infection

When screening tests for all 3 infections are negative/not detected add the following comments:

  • negative at time the screening sample was taken
  • please offer testing at any time in pregnancy if the woman has a new exposure risk or develops relevant symptoms

Result 2

For this result, the clinical comments to report are:

  • treponemal antibody detected
  • results consistent with treponemal infection at some time
  • refer immediately for clinical assessment

Result 3

For this result, the clinical comments to report are:

  • treponemal antibody detected
  • results consistent with recent or active treponemal infection
  • refer immediately for clinical assessment

Result 4

Repeat EIA/CLIA on current sample. If the result is reproduced, then report as follows:

  • screening result not confirmed in further tests and is probably non-specific
  • to clarify please repeat 2 weeks from the date of this sample
  • see result 5 below

Result 5

If the EIA/CLIA gives the same results on repeat sample, then report as follows:

  • results unchanged from previous sample
  • discrepant results due to false positive screening test
  • no action required

Result 6

This is an unusual pattern of results. Repeat all tests on current sample. If the results are reproduced, then report as follows:

  • inconclusive results
  • to clarify please repeat 2 weeks from the date of this sample
  • see result 7 below

Result 7

If the repeat sample produces the same results send both samples to the reference laboratory and delay reporting until the reference laboratory report is received.

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