RPR Results After Syphilis Treatment: Key Questions Answered

RPR values after syphilis treatment?

On November 12, the hospital reported VDRL/RPR 1:64X Reactive.
After receiving a dose of Benzathine Penicillin at the hospital, I was informed to return for testing in three months.
On December 24, during a health check, the laboratory reported STS (RPR) 1:32 Reactive.
I would like to ask:
1.
Are the hospital report of VDRL/RPR and the laboratory report of STS (RPR) the same test? The hospital report has 1:64X, while the laboratory report does not include (X)?
2.
Since it has not been three months and the test was done early, does a reduction to half indicate successful treatment?
3.
More than a month after syphilis treatment, the erythema has not increased, but there are still some faint red spots on my abdomen that have not disappeared.
Is this normal?

Mr. Zhang, 40~49 year old female. Ask Date: 2021/12/25

Dr. Chen Jiansheng reply Urology

Serologic test of syphilis (STS) primarily utilizes VDRL and RPR for testing.
It is advisable to track the test results at a single laboratory for better comparability.

Reply Date: 2021/12/25

More Info

Understanding RPR Results After Syphilis Treatment: Key Questions Answered
When dealing with syphilis treatment and monitoring, it's essential to understand the implications of RPR (Rapid Plasma Reagin) test results and how they relate to treatment efficacy. Based on your questions, let's break down the key points regarding your situation.

1. Are the VDRL/RPR tests from the hospital and the STS(RPR) from the lab the same?
Yes, both VDRL (Venereal Disease Research Laboratory) and RPR are non-treponemal tests used to screen for syphilis. They measure the presence of antibodies that are produced in response to the infection. The "X" in the hospital report likely indicates a specific dilution factor or a particular testing protocol, but fundamentally, both tests aim to detect the same antibodies. The results you received (1:64X and 1:32) indicate the degree of reactivity, with higher numbers suggesting a greater presence of antibodies. The difference in dilution ratios reflects the testing methodology but does not change the underlying purpose of the tests.

2. Is a decrease from 1:64X to 1:32 after treatment an indication of treatment success?
A reduction in RPR titers is generally a positive sign and suggests that the treatment is having an effect. However, it's important to note that a significant drop in titers is expected over time, typically assessed at the three-month mark post-treatment. While a decrease to 1:32 is encouraging, it does not definitively confirm treatment success. The standard for treatment success is usually a fourfold decrease in titers (e.g., from 1:64 to 1:16) at the three-month follow-up. Therefore, while your results are promising, continued monitoring is essential.

3. Is it normal for some rashes to persist after treatment?
Yes, it is not uncommon for skin manifestations, such as rashes, to persist even after successful treatment of syphilis. The immune response can take time to resolve completely, and the presence of residual rashes does not necessarily indicate ongoing infection. The fact that your rash has not worsened and is not increasing in number is a good sign. However, if you have concerns about the rash or if it changes in appearance, it would be prudent to consult your healthcare provider for further evaluation.

Additional Considerations
- Follow-Up Testing: It is crucial to adhere to the follow-up schedule recommended by your healthcare provider. Typically, follow-up serologic testing is done at three, six, and twelve months after treatment to monitor the RPR titers and ensure they continue to decline.

- Transmission Risk: While treatment reduces the risk of transmission, it is advisable to practice safe sex (e.g., using condoms) until you have confirmed that your RPR titers have decreased appropriately and that you are no longer infectious.

- Emotional and Psychological Support: Dealing with a syphilis diagnosis can be stressful. It’s important to seek support from healthcare professionals, counselors, or support groups if you feel anxious about your health or the implications for your relationships.

In conclusion, while your initial results show a positive trend, continued monitoring and follow-up testing are essential to confirm treatment success. If you have any further questions or concerns, do not hesitate to reach out to your healthcare provider for personalized advice and support.

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