Pale Treponema Test (TPHA) (Syphilis)

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Pale Treponema (Treponema pallidum) Is a bacterium (pale spirochete) that causes syphilis. Syphilis is an infectious disease that is transmitted mainly through sexual contact. It can also be transmitted through transfusions and transplants, and through close household contact.

Its incubation period is 10-90 (usually 14-21 days) days before the development of chancre (painless genital ulcer).

Syphilis can be congenital and acquired:

  • Acquired syphilis: Early (primary, secondary, early latent) and late infection;
  • Congenital syphilis: Early and late infection.

In the absence of intercurrent antibiotic therapy, the disease affects various organs.

Acquired syphilis Clinical manifestations depend on the stage of the disease:

Primary syphilis Clinically manifested by the presence of chancre and adenopathy. The presence of chancre can last from 2 to 6 weeks and may experience spontaneous regression even in the absence of specific treatment;

Secondary syphilis Clinically manifested by rash on the mucous membranes and skin (torso, face, hands), sometimes accompanied by fever, arthralgia, polyadenopathy, hepatitis, uveitis. Clinical signs are manifested from 6 weeks to 6 months after chancre development. The rash can last from a few days to a few weeks. In the absence of specific treatment, the rash can develop in several stages, ending with an asymptomatic period of 1-2 years. Spontaneous regression of the rash is possible even in the absence of treatment;

Early latent syphilis and late latent syphilis are stages of infection that proceed without clinical symptoms. Diagnosis of the disease at such asymptomatic clinical stages is impossible without the aid of serological tests;

Tertiary syphilis Revealed in the clinical picture of the skin-related (gingival), neurological (progressive paralysis) and cardiovascular (syphilitic aorta, aortic aneurysm, coronary stenosis) systems. Signs appear in the period from 4 to 40 years after the development of the initial chancre.

Congenital syphilis. The risk of transplacental transmission of the infection increased its importance during pregnancy. Interpreting the results of immunological tests in a pregnant woman is difficult because of the possibility of false positive reactions related to pregnancy. Transplantation of the disease may develop: signs of sepsis leading to fetal death, premature birth, and neurological damage that manifests itself later.

The following research methods are used to diagnose and monitor the effectiveness of treatment for Treponema pallidum infection:

  • Direct detection of the pathogen: microscopy, direct immunofluorescence reaction (RIF), molecular methods (PCR analysis);
  • Indirect detection of the pathogen (serological markers of infection).

Is based on the serological diagnostics of syphilis Treponemic and nontreponemic tests.

The primary immune response is represented by IgM-type specific anti-treponemic antibodies, which are detected at the end of the 2nd week of infection; Anti-treponemic IgG antibodies appear later, in the 4th week. thus, Most patients have IgM and IgG antibodies in their blood at the onset of clinical symptoms. Specific IgM antibody levels decline rapidly after adequate treatment for early syphilis, but persistence of specific IgG antibodies persists until the end of life. The determination of this type of antibody is included in a set of treponemic tests.

Rapid test for syphilis antibodies  Used to qualitatively and selectively detect antibodies against T. pallidum (IgG, IgM and IgA) in whole blood, serum or plasma. The sensitivity of the test is 99.54%, the specificity - 100%.

When should we take the test?

IgM and IgG Determination of antibodies:

  • Diagnosis of syphilis in individuals with clinical signs of syphilis;
  • Exclusion of syphilis during any genital ulcer;
  • Examination of sexual partners of patients with syphilis;
  • Examination of infants and children, first month of life, in case of maternal syphilis during pregnancy;
  • Positive result of screening test;

IgM Antibodies Are a serological marker of the acute stage of infection caused by Treponema pallidum.

How to prepare for a quick test on a pale treponema?

The test should be performed on an empty stomach.

Research material

Venous blood

Possible interpretation of the results

IgM Antibodies:

Positive result:

  • Early syphilis (2 weeks to 3 months after infection);
  • Congenital syphilis of the newborn.

Negative result:

  • Infection is not noted;
  • Early period of infection (up to 2 weeks);
  • Early syphilis (late stages, on average, 3 months after infection);
  • Late syphilis;
  • Disease of the past.

IgG Antibodies:

Positive result:

  • Early syphilis (4 weeks after infection);
  • Late syphilis;
  • Past illness;
  • In the newborn, congenital syphilis or maternal antibodies (if the mother is infected)

Negative result:

  • Infection is not noted;
  • Early period of infection (up to 4 weeks).





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