How to take a blood test for the Wasserman reaction - test indications, preparation and interpretation of the results. False positive reaction to serological tests for syphilis In what cases is a positive anal

Content

Syphilis is a common sexually transmitted disease, if it is not detected in time, the body will suffer serious damage and death is possible. The Wasserman reaction is a special analysis that should be done if this pathology is suspected; timely diagnosis will help to immediately cure the disease if the result is positive. You can become infected with syphilis not only through sexual contact, but also through household items, hygiene products, and bedding.

Methods for diagnosing syphilis

Tests should identify the main causative agent of the disease - treponema pallidum, also known as treponema pallidum. To do this, blood is drawn on an empty stomach for serological analysis. Such a study is considered to be the main type of laboratory diagnostics for detecting syphilis. The most common research methods are:

• blood test for RW (RW) - Wasserman analysis;
• RPHA – passive hemagglutination reaction;
• ELISA – enzyme immunoassay of blood;
• RIF – immunofluorescence reaction;
• RPR – microprecipitation reaction with cardiolipin antigen;
• RIBT – immobilization reaction of Treponema pallidum.

What is the Wasserman reaction

This is a laboratory blood test for syphilis, which is aimed at determining the immunological reaction to the penetration of the pathogen into the body. Characteristic processes begin in the human body during infection. The causative agent of the disease contains the antigen cardiolipin. The patient's blood serum, due to the presence of reagins in it, enters into a complement fixation reaction. The result is a specific complex with this antigen, which RV can detect.

When infected with syphilis, a person will definitely have antibodies to Treponema pallidum in his blood, which is characterized as a physiological response of the immune system. During the test, the drug cardiolipin is added to the collected blood. If the causative agent of syphilis is already in the body, the result will be visible RSC, which binds the introduced antigen and antibodies. In the decoding, the number of “+” signs indicates the intensity of the formation of complexes or “-” in their absence.

Indications for the study

It is recommended to regularly conduct a general blood test in order to promptly identify any abnormalities in the human body; staging the reaction at an early stage can significantly increase the effectiveness of treatment. The following indications exist for donating serum to RW:

1. During professional examinations and medical examinations on a regular basis for employees of trade, medicine, and education.
2. During pregnancy. There is a possibility of infection of the fetus with syphilis in the womb, so it is important to identify the result of the Wasserman test in women who are planning to give birth to a child or are already carrying one. Pathology can cause serious harm to the baby.
3. People who have had long-term contact with pathology at work or at home.
4. If a person suffers from alcoholism or drug addiction.
5. During urgent hospitalization of a patient with signs of syphilis.
6. After intimacy without using a contraceptive with a random person.
7. Anyone wishing to become a blood or sperm donor must be tested.
8. If the pregnancy was terminated unnaturally.
9. The test is carried out during and after serving time in prison.
10. The reason for performing RV is the hospitalization of a patient with enlarged nodes of the lymphatic system and elevated temperature.

Blood for the Wasserman reaction during pregnancy

This is the initial test that your OB/GYN will ask you to take. A blood test for the Wasserman reaction may be inaccurate because the woman’s condition during this period affects the results. According to statistics, 32% of cases show a false positive result. If there is a “+” in the decoding, it is necessary to undergo differential diagnosis. It is recommended to perform the test once per trimester, regardless of the presence or absence of sexual intercourse. There are no contraindications for RW for pregnant women; this is a standard collection of material.

Preparation

Some tests require specific preparation before taking. Wasserman's analysis will be as reliable as possible if 2 days before the test you do not drink any alcoholic beverages (even low-alcohol ones). It is recommended not to eat fatty foods during this period, so as not to distort the results. You should not take any digitalis preparations while preparing for RV.

How is the procedure performed?

Blood for the Wasserman reaction is carried out only on an empty stomach, this is an important condition. The last meal before collection should be no later than 6 hours. The employee who performs the manipulations sits the client on a chair or places him on a couch. The analysis requires 8-10 ml of blood from the cubital vein. If the study is carried out on a small child, then the material can be taken from the jugular or cranial vein.

How many days does a blood test for RW take?

There are two stages in conducting material research. Wasserman's rapid test will be ready in 2 hours, but it can only confirm or refute the presence of syphilis antibodies in the patient. To obtain quantitative information on the state of the blood and the concentration of antibodies to treponema, it takes from 1 to 7 days. The duration of analysis and interpretation depends on the laboratory and the number of ongoing tests.

Decoding

A blood test according to Wasserman should only be deciphered by a qualified doctor. The results may indicate not only a negative or positive reaction, but also something in between. Only a specialist will be able to correctly interpret the data and not frighten the patient ahead of time. A typical negative result is indicated by a “-” sign and indicates the undoubted absence of syphilis in the human body.

Positive reaction

When assessing the concentration of antibodies, a positive manifestation may be marked by one, two, three or four pluses. The following symbols may appear in the decoding:

1. “+” and “++” - the result indicates a dubious, weakly positive microreaction. Additional diagnostic tests and examination are necessary. After some time, you can repeat the analysis of August Wasserman, because there is no complete confidence in the absence or presence of syphilis. The reason for this result may be a violation of the preparatory procedures before donating blood.
2. “+++” is a positive reaction. No additional or repeated confirmation is required; the patient has syphilis and must undergo a full examination. Women are prescribed a smear from the vagina or uterus, men donate material from the urethra. This result is rarely erroneous, but clarifying tests may be prescribed if the patient’s symptoms are similar to other diseases.
3. “++++” is the final positive result. High reaction intensity.
4. “++++” is the final positive reaction. The result obtained is 100% reliable and does not require any additional analysis. The diagnosis is syphilis.

False-positive Wasserman reaction

An absolutely healthy person can receive such an answer; this happens for specific reasons. This reaction occurs if the patient has acute or chronic stages of the disease, has recently received vaccinations, or has recently suffered physical injury. All these conditions lead to the active production of a nonspecific protein in the body, which is called antibodies or immunoglobulin. The RW analysis is aimed at identifying these proteins and recognizing them as syphilitic. This becomes the basis for obtaining a false positive result.

Causes

It was described above why a patient may receive a false positive result when testing for syphilis. Here is a list of conditions that can lead to this:

• myocardial infarction;
• alcohol, food poisoning;
• acute, chronic liver pathologies, hepatitis D, C, B;
• soft tissue or bone injuries;
• age-related changes in the functioning of the patient’s body;
• tuberculosis;
• autoimmune diseases.

Video

Attention! The information presented in the article is for informational purposes only. The materials in the article do not encourage self-treatment. Only a qualified doctor can make a diagnosis and give treatment recommendations based on the individual characteristics of a particular patient.

Found an error in the text? Select it, press Ctrl + Enter and we will fix everything!

Discuss

How to take a blood test for the Wasserman reaction - test indications, preparation and interpretation of results

HIV infection is one of the most dangerous diseases today. This disease is viral in nature and is transmitted only from person to person. Infection occurs through contaminated blood, semen, and vaginal secretions. Today, a number of laboratory tests are used to diagnose this infection, which can confirm or deny the presence of infection in the human body. It is no secret that sometimes in laboratory practice a false positive result for HIV occurs.

Reliability of HIV results

Possible reasons for a false positive result when testing for HIV infection

There are a number of diseases, pathological conditions and other factors that can potentially give a false positive result:

• cross-reactions with antibodies to other viral or bacterial infections;
• pregnancy, especially if a woman is not giving birth for the first time;
• various lung diseases of an infectious nature;
• infection with viral hepatitis;
• acute stage of influenza condition with serious mobilization of the immune system in the body;
• abnormalities of the blood coagulation system;
• conditions after organ and tissue transplantation;
• certain periods of the menstrual cycle in women with abnormal hormonal changes;
• an increase in the concentration of certain substances in the blood (for example, bilirubin).

Cross-reactions are one of the most common causes of false positives from the laboratory. The fact is that various allergic diseases, including those of an autoimmune nature, are common among the population. At the same time, the body’s immune system is constantly on high alert and produces a variety of antibodies in large quantities. During an HIV test, they enter into a chemical reaction with the reagent, and the equipment gives a false reading.

Carriage of one or another viral infection is also a fairly common cause of error. For example, it could be a hepatitis virus or a herpes virus. Therefore, if a positive result for HIV appears, it is necessary, in addition to conducting additional studies for this infection, to check the person for carriage of pathogens of other viral diseases. It is worth noting that the situation of simultaneous infection with several infections is often encountered.

If the patient underwent an organ or tissue transplant within several months before being tested for HIV, then a false test result is quite common. This is due to the fact that the transplanted organ, for example, the liver, is initially and then gradually rejected. This occurs with the direct participation of the immune system, which produces a complex of a wide variety of antibodies. These antibodies, produced by the body in response to foreign tissue, react with the reagents of HIV test systems.

Sensitivity of methods

Important! Before taking an HIV test, if it is not carried out anonymously, the doctor must be warned about the state of pregnancy, recent operations and other medical procedures.

Testing for HIV infection at home

Recently, in many developed countries of the world, portable test systems for self-examination for HIV infection at home are being distributed. The reagent used in these systems is capable of detecting the presence of infection in the human body in record time.

There are three types of diagnostic kits intended for home use by anyone:

1. A kit for testing saliva for the presence of HIV.
2. Kit for testing urine for the presence of HIV.
3. Kit for testing blood for HIV.

Home test

Each of these methods has its own advantages and disadvantages. For example, a kit for testing salivary fluid is the easiest to use. This is due to the fact that the test requires saliva, which is very easy to obtain. It is believed that the other two options give a slightly more accurate result. But experts talk about the equal value of all three types of home test systems. The disadvantage of a kit for analyzing a drop of blood is that you need to damage your own skin and follow the rules of asepsis.

False positive result in pregnant women

It is widely known that during pregnancy, an HIV test can give incorrect results. This is due to the fact that serious hormonal changes occur in the body of a pregnant woman. At the same time, the immune system of the expectant mother is also involved in vigorous activity.

A spectrum of various antibodies is produced. Many of them are very important for the baby’s health, as they penetrate the placental barrier and provide the child with immunity in the first months of life. But these antibodies can very easily interact with reagents in HIV testing systems.

If a medical error occurs

If you receive a positive result when testing for HIV infection, you should not panic. Firstly, it is imperative to repeat the analysis in another laboratory and, preferably, using a different test system. This recommendation is made by the relevant committee of the World Health Organization, which deals with the prevention and treatment of HIV infection.

When a positive antibody test is obtained again, reliable confirmation of the presence of the virus in the blood by another method is necessary. It can also be repeated in another laboratory. Only after this can we talk about the presence of HIV infection in the human body. Also, do not forget about the above reasons when the test gives an incorrect result.

Important! When performed correctly, the method for determining the viral particles themselves in the blood rarely gives an incorrect result. Although such cases are not excluded.

If the results of previous incorrect diagnoses were caused by errors of medical workers, then any citizen has the right to apply to the judicial authorities to receive appropriate compensation for moral damage. But rarely does anyone use this right, as people are afraid of being discriminated against and stigmatized.

How to take the test yourself

To conduct an independent examination for HIV infection at home, you must have a special kit designed to test a particular biological fluid. The secretion being tested (a drop of blood, saliva or a small amount of urine) is placed in a special container or jar with a reagent. After this you need to wait 15-20 minutes.

Modern test systems give three variants of results: positive, negative and doubtful.

If a questionable result is obtained, it is recommended to repeat the study after some time. According to experts, modern test systems for home use are quite accurate. The accuracy of the determination, according to some authors of scientific articles, reaches 99%.

However, to make a final diagnosis, an examination is necessary in a modern medical laboratory, which has the full range of modern methods for diagnosing HIV infection. Prescription of treatment for a confirmed diagnosis is carried out only in a medical institution by qualified specialists.

A person has to take a test to determine syphilis almost more often than anyone else: hiring, medical examinations, preventive examinations, pregnancy. Performing these studies is necessary - they allow you to identify the disease in the early stages, when treatment will be most effective.

The resulting positive result often baffles a person, especially in the absence of any reason. Detection of false-positive syphilis is a fairly common occurrence, and therefore you should not give in to panic ahead of time. According to information from various sources, up to 30% of primary studies may give an incorrect result. There are many reasons for this phenomenon: changes in the state of the body, somatic diseases. To better understand why false data appears, it is worth taking a closer look at the research question.

Types of tests for syphilis

Clinical research methods are rapidly improving every year. With the development of new diagnostic methods, a false positive reaction to syphilis is becoming less common. If necessary, diagnostics can include several different methods - this allows you to obtain the most reliable result.

Non-treponemal research methods

These techniques are aimed at identifying proteins that are formed as a result of the activity of the pallidum spirochete. They are aimed at identifying “traces” of the pathogen. Such methods have a relatively high percentage of error (up to 10%). Such techniques are nonspecific, but they allow the degree of infection to be determined by the antibody titer.

Wasserman reaction RW

The most common test performed to identify Treponema pallidum is a serological blood test. The Wasserman reaction allows you to determine the presence of the disease in just a few minutes. Therefore, this technique is most often used in laboratories - it does not require much time and has a relatively low cost.

The test uses cerebrospinal fluid or blood. The test material can be collected from a finger (if there is only one analysis) or from a vein (if several studies are required). When performing an analysis, there can be not only a false positive, but also a false negative result. It is possible under the following circumstances:

• early stage of infection, when the number of treponemes in the body is still low;
• a chronic disease in the subsiding stage, when the number of antibodies decreases.

Note! A false negative result occurs extremely rarely, and therefore if there is at least one positive result out of four, it is necessary to undergo additional examination.

Recipitation microreaction (MR)

This research technique is based on the antigen-antibody reaction. It requires a small amount of material to complete. Aimed at identifying antilipid antibodies that are produced during the destruction of treponema cells. Both the patient's blood and cerebrospinal fluid are used for the study.

Because cell destruction can occur in other areas than syphilis, the test is used as a screening test rather than a confirmatory test. There are two analogues of this technique:

• Microscopic test (VDRL). Inactivated blood serum is used to perform the analysis. If syphilis damage to the nervous system is suspected, cerebrospinal fluid is used as the test material.
• Macroscopic test (RPR). It is considered a rapid diagnostic method. Visual counting of plasma reagins is used.

If the required sterility is not observed, this reaction may give a false positive result. The appearance of such an analysis is also possible with nonspecific tissue damage, which entails the destruction of lipids. If there is a positive result, a mandatory treponemal test is recommended for confirmation.

Treponemal research methods

This category of analysis provides the most accurate data, and there are rarely false positive results. Research is aimed at identifying specific proteins that are released by the body in response to infection. These methods have a higher cost, and therefore are used as confirmatory rather than screening ones.

Specific antibodies begin to be produced by the body only a few weeks after infection with treponema. They can persist for a long period after the disease is cured. Therefore, specific tests may show positive results for a long time after remission.

Note! If the RW analysis is positive and the treponemal test is negative, a repeat study is performed after a few weeks.

Enzyme immunoassay (ELISA, EIA)

It is based on assessing the level of immunoglobulins of the IgA, IgB and IgM classes. The first two types of proteins are produced in the body already from the 2nd week of infection, and IgM - a month after infection.

Read also on the topic

How does pregnancy and childbirth proceed after syphilis?

The analysis is interpreted based on the ratio of the presence of immunoglobulins:

• only IgA was detected – no more than 14 days have passed since infection;
• IgA and IgB were detected – infection occurred 14 to 28 days ago;
• all three types were detected - syphilis in the body for more than 28 days;
• Only IgM was detected - late syphilis.

The presence of IgM may be a sign of already cured syphilis - the synthesis of IgM immunoglobulins can continue for several months after remission.

Immunofluorescence reaction (RIF, FTA)

Used to confirm infection at the earliest stages. For the study, blood is taken from a finger or vein. The result is similar to the RW analysis, where a minus is indicated, or from 1 to 4 pluses. If there is at least one plus, additional research may be prescribed.

False-positive results when performing RIF are extremely rare - they can occur in pregnant women, as well as in patients with connective tissue diseases.

Passive agglutination test (RPHA, TPHA)

The antibody titer allows you to determine the presence of syphilis and its stage. This technique provides reliable data already from 28 days after infection. Blood from a finger or vein is used for assessment. An increase in the number of antibodies means a later stage of the disease.

The most accurate research methods

Analyzes in this group are highly sensitive, and therefore the error in their results is extremely low. They are distinguished by a higher cost, compared to other methods, and a more complex execution technique.

Polymerase chain reaction (PCR)

PCR analysis is considered one of the most highly accurate. It is aimed at identifying areas of pathogenic DNA in the human body. The method requires specialized equipment and reagents, and therefore is used in rare cases.

Immunoblotting

Combined research method. Aimed at determining immunoglobulins in the patient’s blood serum. The analysis checks for the presence of a complex of antibodies, which is used to establish the diagnosis. This technique uses electrophoresis, which separates immunodeterminants, and an ELISA reaction, which reveals the separated points.

Treponema pallidum immobilization reaction (TPI)

A highly specific test that determines the response of blood serum to Treponema pallidum. It is widely used all over the world because it has a high probability of accurate results. Special antibodies (immunomobilins) in a patient with syphilis can immobilize treponema. There are no such antibodies in the blood of a healthy person. It is on the presence/absence of this ability that the research methodology is based.

RIBT is used to identify those varieties of syphilis in which the Wasserman reaction gives negative results - damage to the nervous system, internal organs, and a latent form of the disease. A false positive result is extremely rare in the CIS countries. The cause of its appearance may be sarcoidosis, leprosy.

Causes of false positive results

The Wasserman reaction can determine “acute” and “chronic” false-positive results. Its severity depends on the nature of the changes in the person’s condition. RW can indicate the stage of exacerbation in the following cases:

• infectious diseases in the acute stage;
• traumatic injuries;
• myocardial infarction;
• administration of any vaccine several days before the test;
• food poisoning.

These conditions are characterized by increased functioning of the immune system, which leads to increased production of antibodies. They are mistakenly recognized in the reaction as antibodies to treponema, and therefore a positive result occurs.

In the presence of chronic pathologies, the immune system produces a large number of nonspecific antibodies that can cause a reaction. In RW, such a condition may show a false positive result. Therefore, it is worth warning your doctor about the following diseases:

• chronic pathologies of connective tissues;
• tuberculosis;
• chronic diseases of viral etiology: HIV, hepatitis B, C, D;
• chronic liver diseases;
• autoimmune pathologies.

Read also on the topic

Can syphilis be inherited?

With age, redox reactions in the patient's body slow down. Aging tissue can also show a false positive result, and therefore more accurate research methods are prescribed for elderly patients.

Note! If the Wasserman reaction is positive, an additional study is carried out, which allows one to obtain a more accurate picture, for example, an enzyme-linked immunosorbent assay.

Recheck

A repeat test for syphilis is carried out if the results of the screening test are questionable. It is prescribed if there are one or two crosses - such an analysis requires additional verification. The test can give false positive results in several cases:

• Early stage of the disease. Before the appearance of chancre, the amount of immunoglobulins in the body is quite low.
• Late stage of the disease. More than 2 years have passed since the infection, and the antibody titer gradually began to decline.

A repeat analysis, which is carried out after 2-3 weeks, shows exactly whether there is a disease. If there is a positive result a second time, additional clarifying techniques are used.

Tests during pregnancy

One of the most unexpected results may be a positive test result for syphilis in pregnant women, especially if the woman has not changed partners. This situation often terrifies expectant mothers, since treponema can negatively affect the baby’s intrauterine development.

A screening test during pregnancy is carried out several times:

• upon registration, at 12 weeks;
• beginning of the 3rd trimester, at 30 weeks;
• before childbirth.

This is the amount of research that is considered minimal. A false positive test for syphilis may occur due to changes in the body that occur during pregnancy. When a woman is pregnant, her immune system produces a large number of antibodies - this is an evolutionary adaptation to protect the baby in the first year of life.

During pregnancy, an additional clarifying analysis is prescribed, which is characterized by greater accuracy. If a control study shows the presence of a pathogen in the body, treatment is required. The effect of therapy on a growing organism is significantly less than the possible harm from treponema.

How to prepare for tests?

One way to prevent an incorrect result is to prepare for testing. Due to improper preparation, reactions may occur that are accompanied by the production of nonspecific antibodies, which leads to an incorrect result.

• The test must be taken on an empty stomach. You can only drink clean water.
• A day before blood sampling, you should completely eliminate alcohol - it creates additional stress on the liver, which can lead to a positive result.
• It is recommended to avoid eating fatty and fried foods, spicy foods and large amounts of spices the day before.
• It is recommended to refrain from smoking at least 60 minutes before the test.
• Before drawing blood from a vein, you need to rest for 10-15 minutes in the emergency room.
• Women are not recommended to donate blood during menstruation.
• Analysis cannot be carried out after X-ray examination or physiotherapeutic procedures.
• It is prohibited to donate blood for syphilis during periods of exacerbation of infectious diseases.

Note! If the patient is taking any medications, he should consult a doctor before the test; a break of several days may be required between taking the drugs and the test.

What to do if syphilis is confirmed?

There is no need to worry if you receive an initial screening with positive results. False syphilis is easily determined by repeated testing. If the diagnosis has been confirmed, you need to take measures:

• examination of the sexual partner by a dermatovenerologist;
• examination of close relatives;
• performing preventive treatment to prevent infection in loved ones;
• registration of sick leave for the period of treatment - the sick leave does not contain information about the diagnosis, guaranteeing confidentiality;
• At the end of the course of treatment, a special certificate is issued - you need to have it with you in order to avoid questions about false positive results in the next few months.

A positive result for syphilis is not always reliable. Therefore, there is no need to worry and it is recommended to wait for additional research. Proper treatment, which was started on time, guarantees a quick recovery with a minimum of residual effects.

Many venereologists with many years of experience sometimes encounter difficulties when making a diagnosis such as syphilis. According to statistics, over the past few years, more than 14% of patients have been misdiagnosed.

False syphilis is a reason for panic among many people. Indeed, in the complete absence of such an infection as treponema, they are given a similar diagnosis. What to do in this case and whether there is any threat to health, we will consider below.

A false positive reaction to syphilis is most often observed when the test is primary. The patient undergoes tests during the next medical examination, preventive or targeted. It is recommended for everyone to carry out such tests; in medicine they are called screening or non-treponemal tests.

Because misdiagnosis is common, treatment should not be started immediately after receiving it. First of all, this is due to the peculiarity of such tests; they can react and give a similar result with the development of some other diseases: inflammatory process, destruction of cells in the body, etc.

In order to confirm or refute the fact of infection, it is necessary to conduct a repeated study, as well as perform immunological tests. The photo below is an example of how the tests are carried out.

In modern venereology clinics, every doctor can explain to his patient the following: in order to obtain information about the presence or absence of a disease, it is necessary to donate blood for tests. A nontreponemal test is performed. Only if the presence of treponema in the body is confirmed, an accurate diagnosis can be made and appropriate treatment prescribed.

If you wish, you can, of course, go to a medical facility yourself to undergo an examination. But this is not recommended because if you choose the wrong type of examination, the risk of getting incorrect results is high.

Why are the tests false positive?

A false positive result for syphilis most often occurs when the primary diagnosis is carried out and a non-treponemal test is used for this. Such analyzes include the following: Wasserman test, RSC, etc.

Tests are necessary, first of all, to detect antibodies to cardiolipin in the patient’s blood. Moreover, such a reaction can be observed not only with the development of syphilis, but also with any other pathology associated with the inflammatory process.

The reason that the result turns out to be false is the reaction of the cardiolipin test. When conducting an analysis, the goal is not to identify the pathogen, but to look for the presence of antibodies that can be produced to a component of the heart or skeletal muscles.

A similar reaction can be observed with syphilis and not only. Thus, we can conclude that non-treponemal tests give a positive response not only when in contact with pathogens (treponema), but also when reagin antibodies appear. That is why, if suddenly the analysis gives a positive result, then the next test that should be carried out without fail is treponemal.

The video in this article explains in more detail how the test is performed.

False treponemal analysis

Treponemal tests are specific tests performed to detect syphilis. Their results rarely give the wrong result. Based on the test results, it is possible to identify a syphilitic reaction, both at an early stage of infection and at a late stage.

Such analyzes include the following:

• immunoblot method;
• passive hemagglutination reaction;
• tests for immobolization of pallid spirochetes.

Situations when a patient who has taken the test receives a false-positive ELISA or other treponemal test occur quite often. It is almost impossible to say exactly why the results are positive. This may be associated with some rare pathologies or other infectious diseases.

Many doctors are of the opinion that the reasons for false-positive test results lie in the patient's medical history. So, for example, if there was previously contact with the pathogen, but infection did not occur, immune memory cells will produce antibodies against treponema.

Important! The person continues to remain healthy and not dangerous to others.

When is a syphilis test false positive?

A false result for syphilis is much more common among individuals in a certain category. Among all the tests that showed a positive result, but were not confirmed upon further examination, experts identified several groups of patients whose medical history included the following:

• the presence of autoimmune diseases: dermatomyositis, scleroderma, systemic lupus, arthritis, etc.;
• oncological diseases during the development of which blood cells and lymphoid tissue were affected;
• patients with tuberculosis;
• patients with hepatitis, mononucleosis;
• patients who take drugs for a long time, as well as people who abuse alcoholic beverages;
• Patients have been vaccinated within the last 28 days;
• patients over 65 years of age;
• pregnant women.

As you can see, a false test result can be given in the presence of certain pathologies and conditions.

The diagnosis is carried out by a venereologist and he conducts a high-quality examination. If a questionable result for syphilis is obtained, the patient is sent for additional examination.

You should not look for information in the press or on the Internet about how to independently identify syphilis. This examination cannot be successful, and can sometimes be dangerous.

The whole point is that if an unreliable result is obtained, there simply cannot be any talk about any correct treatment. Any instructions for taking medications are issued by a doctor. Taking anything on your own is prohibited.

False positive result in pregnant women - how to avoid?

Pregnant women need special diagnostics, especially if they have been misdiagnosed. Most often, such results are given against the background of antiphospholipid syndrome during pregnancy, as well as in the presence of other chronic diseases in the anamnesis.

Only experienced specialists should carry out the examination. In order to be diagnosed, women need to undergo a full examination. The necessary tests are prescribed and the patient’s complaints are taken into account.

Treponema infection for the fetus is extremely dangerous, which is why treatment should begin only if the diagnosis is confirmed. An experienced specialist has the right to develop a treatment regimen.

Important! The health of a pregnant woman should be monitored for all 9 months.

Currently, a false-positive test for syphilis is extremely rare. The examination for the detection of sexually transmitted diseases should be carried out under the supervision of a venereologist.

Complications from syphilis

If the diagnosis was not false and syphilis actually develops, then the main question that patients ask is: what complications can they expect?

Most patients are embarrassed to admit that they suffer from a pathology, considering it something shameful. Many people really try to avoid such people so as not to get infected. Most patients put off visiting a doctor until the last minute, fearing publicity and all that.

Behaving in this way is not acceptable, since you can not only infect others, but also harm yourself even more. The consequences and complications of syphilis in its advanced form can be serious and irreversible. It could be about the patient's life.

The disease can lead to the development of the following pathologies:

1. Neurosyphilis- This is complete or partial damage to brain cells. They are sensitive and simply cannot withstand a strong bacterial attack. Syphilitic meningitis can lead to the death of brain tissue. The patient will gradually begin to suffer from dementia, his vision and memory will deteriorate. Complete damage to the brain will lead to paralysis, and it can affect the entire body.
2. Diseases of the cardiovascular system. Treponema pallidum can spread through veins, capillaries and arteries. Due to the presence of the microbe, the walls of the aorta and blood vessels will be destroyed. Your health will begin to deteriorate, and problems with blood circulation and blood pressure will appear. In advanced cases, this can lead to a heart attack.
3. The musculoskeletal system will be destroyed. Bacteria have an extremely negative effect on cartilage and bone tissue. As microbes decompose, tissues will begin to decompose and die. It is possible to form fistulas that will come to the surface of the skin. As a result, the ability to move will be lost.
4. The liver atrophies. During the treatment period, a double load is placed on the organ. Treponema affects it, and antibiotics weaken it. The result is acute yellow liver atrophy. The organ decreases in volume and functionality will be lost. The patient falls into a coma and dies.
5. Breathing processes will be disrupted. As a result of destructive processes in the organs of the lung tissue, shortness of breath will occur, and there may not be enough air when breathing. Even minor physical exertion can cause the patient to begin to choke. A person can die from asphyxia.
6. Skin diseases. The pathology spreads especially strongly to the perineal area.

Syphilis can affect the gastrointestinal tract. Digestive problems arise.

Constant symptoms for the patient are constipation, diarrhea, etc. Complications after syphilis are not common. In order to return to a full life, you should undergo timely treatment and follow basic preventive measures.

Frequently asked questions to the doctor

Pregnancy and syphilis

Good afternoon. Several years ago I was treated for syphilis, but I am still registered with a venereologist. I visit the hospital once every three months to get my blood tested. Not long ago, the results showed a positive result, and I also found out that I was pregnant. Tell me, is this a re-infection or the result of pregnancy?

Firstly, there is no need to panic ahead of time. In a condition such as pregnancy, it is possible that the tests may be false positive.

You should visit the doctor again and get tested again - RIF, RPGA, immunoblotting. Based on the results obtained, it will be possible to judge whether an error occurred or not. Timely measures taken will help avoid infection of the fetus.

Infection through a condom

Hello, tell me, can I get syphilis from a partner through protected sexual intercourse?

The causative agent of the disease can penetrate to a healthy person through mucous membranes and damaged areas of the skin. In 96% of cases, infection occurs through sexual contact. During sex, a little friction is enough and microcracks will appear on the skin that you may not only not notice, but also not feel. If your partner’s disease is in an acute stage, then infection can occur even if your bodies touch.

The main means of protection is a condom. If you use it correctly, you can still protect yourself from infection. But, if the symptoms of the disease are present in other parts of the body, then infection is inevitable and a condom will no longer be able to save in this case.

When a condom is used incorrectly, it can also cause infection:

• the product is stored incorrectly, so it may break during sexual intercourse;
• the condom size does not match the size of the penis;
• expiration date has expired.

Thus, whether a condom will protect or not will depend only on you.

False-positive serological reactions for syphilis (FPR)- these are positive reactions in people who have never been sick and do not have syphilis at the time of examination. That is, there is no specific infection in the body and there never was, and serological reactions give a positive result.

False-positive or nonspecific results are positive results of serological tests for syphilis in individuals who do not suffer from a syphilitic infection and have not had syphilis in the past.

Erroneous test for syphilis due to technical reasons

Decisional errors may be due to technical errors and errors during research, as well as the quality of reagents. Despite the numerous advantages of diagnostic tools for RPGA, ELISA and RIF and their modifications used for the diagnosis of syphilis, in some cases unreliable test results are noted. This may be due to both an insufficient level of qualifications and professional responsibility of personnel (the so-called non-biological or technical errors), and to the characteristics of the tested samples (biological errors).

Non-biological errors can occur at any stage of research: pre-analytical, analytical, and post-analytical, i.e. when collecting, transporting, storing biomaterial, using chylous, sprouted serum, during repeated freezing and thawing of test samples, as well as when using expired diagnostics, etc. In particular, failure to comply with the storage conditions and periods of diagnostic kits causes a decrease in the sensitivity of the reaction and the receipt of false negative results.

False-positive results can be caused by contamination of the sera of patients seronegative for Treponema pallidum with traces of sera from seropositive individuals, which may occur during the preparation of the sera.

There are many other technical errors that lead to unreliable (false negative and false positive) and questionable research results. Some laboratories do not carry out internal and external quality control of syphilis tests, which leads to diagnostic errors and uncertainty among laboratory doctors in the results of the analysis.

The source of errors when performing nonspecific tests may be the failure to use control sera, uneven concentration of the antigen in the experiment due to insufficient mixing before use, contamination of samples and glassware with microorganisms, violation of the terms and conditions of storage of reaction components, and violation of blood collection techniques.

In modern test systems, recombinant or synthetic peptides have been used as antigens. The former became more widespread. But with poor purification, Escherichia coli proteins get into the mixture of T. pallidum antigens, which leads to false serodiagnosis of syphilis in patients with escherichiosis or in healthy people whose serum contains antibodies to E. coli.

To a certain extent, diagnostic errors include incorrect interpretation of research results.

Acute and chronic DM

In addition to technical errors when performing tests, decision-makers can also be caused by the characteristics of the body. Conventionally, decision makers are divided into spicy (<6 месяцев) и chronic(stored for more than 6 months).

Acute DM can be observed during pregnancy and during menstruation, after vaccination, after a recent myocardial infarction, and in many infectious diseases. Infections in which PPR may occur are pneumococcal pneumonia, scarlet fever, infective endocarditis, tuberculosis, leprosy, lymphogranuloma venereum, chancroid (chancroid), leptospirosis and other spirochetoses, HIV infection, infectious mononucleosis, malaria, chicken pox, viral hepatitis, mumps , measles, respiratory diseases, influenza and dermatoses.

Acute PDs are unstable, their spontaneous negativity occurs within 4-6 months.

Chronic DM possible with autoimmune diseases, systemic connective tissue diseases, cancer, chronic pathology of the liver and biliary tract, cardiovascular and endocrine pathologies, blood diseases, chronic lung diseases, injection drug use, etc. In most of these conditions, anticardiolipin antibodies of the IgG and IgM classes ("reagins").

Chronic false-positive reactions can remain positive throughout life.

Chronic false-positive reactions may be preclinical manifestations of serious diseases. In malignant neoplasms and diffuse connective tissue diseases, the LPR titer can be very high.

Among the causes of chronic positive reactions are physiological conditions (old age). With age, the number of PD increases; in women they are observed 4.5 times more often than in men. In the age group of 80-year-olds, the prevalence of PD is 10%.

The cause of DPR may be the frequent use of intravenously administered drugs, frequent transfusions and infusions.

Chronic infections (tuberculosis, leprosy, infective endocarditis, malaria), myeloma can also cause PD.

Infection with other spirochete species

False-positive reactions of treponemal and non-treponemal tests can be observed in infectious diseases whose pathogens are antigenically similar to Treponema pallidum. These are relapsing fever, leptospirosis, tick-borne borreliosis, tropical treponematoses (yaws, bejel, pinta), as well as inflammatory processes caused by saprophytic treponemas of the oral cavity and genitals.

The causative agents of endemic treponematoses (yaws, pinta, bejel) are treponemas that have genus-specific antigens similar to those of T. pallidum. In this regard, antibodies formed to them are capable of cross-interacting with the antigen of the causative agent of syphilis.

Russia is not a territory endemic for this group of diseases. These infections occur mainly in Africa, Latin America and South Asia, and cases of the disease are rare in the practice of medical institutions.

A patient with positive serological reactions for syphilis who arrived from a country with endemic treponematoses should be examined for syphilis and prescribed anti-syphilitic treatment if it has not previously been administered.

Biological false-positive Wasserman reaction

Beginning in 1938, and especially during World War II, serological screening tests for syphilis became widespread in the United States. The researchers compared the data obtained and found that a positive or questionable reaction was found in people who did not have clinical and epidemiological signs of syphilitic infection or contacts with syphilis. Moreover, such results occurred much more often than previously thought. Positive results of nontreponemal tests with lipid or cardiolipin antigens (VDRL, in Kolmer tests, Kahn reactions) have been found in patients with various diseases, but without signs of syphilitic infection. Biological false-positive results have been identified in patients with autoimmune, inflammatory and hematological diseases.

In Russian-language medical literature, this phenomenon is called “ biological false-positive Wasserman reaction"(B-LPRV), because These results were observed during the most common test of those times - the Wasserman reaction.

It turned out that B-LPRV can occur in two main forms - acute and chronic. In the first case, in patients who have had an infection other than a syphilitic infection, B-LPRV disappears during the recovery process, and the duration of its detection does not exceed six months. In the second case, B-LPRV may persist persistently for many years in the absence of an obvious causative factor. In the early 50s, it was found that chronic B-LPRV is most often detected in autoimmune diseases, especially SLE, in which the frequency of its detection reaches 30-44%

False-positive nontreponemal (cardiolipin) tests

Lipid antigens of T. pallidum make up a significant part of the cell, but the body may also contain lipids with the same structure - autoantigens formed as a result of the destruction of organs and tissues (mainly lipids of mitochondrial membranes).

Syphilitic infection is accompanied by the formation of immune complexes and an autoimmune response to cardiolipin, fibronectin, collagen and muscle creatine kinase. In non-treponemal tests, a solution of three highly purified lipids (cardiolipin stabilized with lecithin and cholesterol) in ethyl alcohol is used as an antigen. Cardiolipin is not a specific component for T. pallidum and is also described as one of the phospholipids of human biomembranes. Therefore, antibodies to this antigen are recorded in serum during almost any alteration of human cells as a result of infections and under some physiological and pathological conditions.

Because the antigen used in non-treponemal reactions is found in other tissues, tests may give positive results in individuals without treponemal infection (1-2% in the general population).

The most common cause of biological false-positive non-treponemal tests is antiphospholipid syndrome, an autoimmune process that occurs in connective tissue diseases (systemic lupus erythematosus, dermatomyositis, scleroderma).

When using non-treponemal tests (RMT and its modifications), false-positive results may be due to the presence in the blood of antibodies to rheumatoid factor, cross-reacting antibodies in autoimmune pathology (“cress reactors”).

Other factors for the occurrence of false-positive results are considered to be some chronic bacterial infections (leprosy, etc.), diseases of viral etiology (infectious mononucleosis), and systemic connective tissue diseases.

Reasons may also include old age (over 70 years), pregnancy, extensive somatic pathology, lipid metabolism disorders, immunodeficiency states of various etiologies, systemic chronic diseases of the heart and lungs.

Other causes include cancer, tuberculosis, enteroviral infections, viral hepatitis, Lyme disease, pneumonia, alcoholism, drug addiction, diabetes, vaccination, other infections (malaria, chicken pox, measles, endo- and myocarditis), gout.

In these conditions, the development of immunological disorders is observed, leading to abnormal production of antibodies that can cross-react with treponemal antigens.

Table. Biological causes of false-positive reactions in nontreponemal serological tests.

Spicy (<6 месяцев)	Chronic (>6 months)
Physiological conditions: Pregnancy Vaccination with some types of vaccines	Physiological conditions: Elderly age
Bacterial infections: Pneumococcal pneumonia Scarlet fever Infective endocarditis	Bacterial and other infections: Infective endocarditis Malaria
Mycobacterial infections: Tuberculosis Leprosy	Mycobacterial infections: Tuberculosis Leprosy
Other STIs: Chancroid (soft chancroid) Lymphogranuloma venereum	Connective tissue diseases: Systemic lupus erythematosus
Infections caused by other spirochetes: Relapsing fever Leptospirosis Lyme borelliosis	Oncological diseases: Myeloma Lymphoma
Viral infections: HIV Infectious mononucleosis Measles Chicken pox Mumps (mumps) Viral hepatitis	Other reasons: Injecting drug addiction Multiple blood transfusions Diabetes

False-positive treponemal tests

Compounding the problem, treponemal tests can also be false positive. The causes may be autoimmune diseases, collagenosis, Lyme disease, pregnancy, leprosy, herpes, malaria, infectious mononucleosis, tumors, drug addiction. In recent years, immunoblotting, one of the most modern methods for diagnosing syphilis, has begun to be actively used abroad to differentiate DM.

Antibody persistence after successful treatment

Specific diagnostic reactions remain positive for a long time even after full therapy. After effective treatment of a syphilitic infection, in most patients, titers in non-treponemal tests decrease by 4 times 6–12 months after treatment. However, with late initiation of therapy, titers even in non-treponemal tests may remain at the same level, but never increase.

False negative test results

Different diagnostic methods demonstrate different sensitivity and specificity depending on the form and stage of syphilis. The likelihood of an erroneous diagnosis increases, especially in cases of latent, hidden, combined course of the disease.

False-negative serological reactions for syphilis can be observed in secondary syphilis due to the prozone phenomenon when testing undiluted serum, as well as when examining immunocompromised individuals, such as HIV-infected patients.

False-negative results of serological specific tests (SSR) caused by biological factors may be due to competition between specific IgM and IgG for binding to the antigen on the surface of erythrocytes, as well as the “prozone phenomenon”. In the latter case, agglutination does not occur due to overproduction of antibodies to Treponema pallidum, since each antigen receptor on erythrocytes, due to excess antibodies, is associated with one agglutinin molecule, which prevents the formation of a “lattice.” Replacing RPGA with TPPA, i.e. erythrocytes on synthetic particles, apparently, will eliminate or minimize the receipt of false negative results.

In ELISA, such reactions can be explained by the presence of a seronegative phase in primary syphilis, and in secondary syphilis - by immune deficiency and the presence of HIV infection. When receiving a negative result from serological tests for syphilis, one should take into account the ability of Treponema pallidum to penetrate and multiply in various organs and tissues - searching for the pathogen in the lymph (lymph nodes) in some cases leads to a reliable result. It is also advisable to repeat the analysis of samples that gave a positive result. Repeated serum testing after 5–7 or more days, as a rule, allows one to obtain reliable results.