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2 Fold Increase in syphilis titre since last test
Tested Syphilis positive with titre 1:32 in March 2018. HIV, Chlamydia, Gonorrhoea, Hep C were negative in March 2018, July 2018, November 2018 and February 2019.
Since the last syphilis test was in September 2017, the doctor diagnosed this syphilis as early latent. Syphilis was detected serologically but the doctor did not complete physical exam. I had a sore right on my anus. I was treated with 1 injection of Penicillin on 27 March 2018. Titres dropped to 1:8 in November 2018 test. The doctor declared that the treatment was successful due to 4 fold decrease in titre.
However, my last test in February 2019 the titre is 1:16. This is a 2 fold increase. Does this mean I am reinfected or does this mean my last treatment was unsuccessful? I haven't received a phone call from the doctor's office as yet but I believe the doctor will not be concerned as there should be a 4 fold increase. I believe he will wait it out until May 2019 when my next tests are scheduled.
Please help me calm down with your expert opinion. Why is there an increase in titre whereas it should be either the same or a decrease?
Since the last syphilis test was in September 2017, the doctor diagnosed this syphilis as early latent. Syphilis was detected serologically but the doctor did not complete physical exam. I had a sore right on my anus. I was treated with 1 injection of Penicillin on 27 March 2018. Titres dropped to 1:8 in November 2018 test. The doctor declared that the treatment was successful due to 4 fold decrease in titre.
However, my last test in February 2019 the titre is 1:16. This is a 2 fold increase. Does this mean I am reinfected or does this mean my last treatment was unsuccessful? I haven't received a phone call from the doctor's office as yet but I believe the doctor will not be concerned as there should be a 4 fold increase. I believe he will wait it out until May 2019 when my next tests are scheduled.
Please help me calm down with your expert opinion. Why is there an increase in titre whereas it should be either the same or a decrease?
COMMUNITY LEADER
I don't blame you. It's hard to say right now if it's a new infection or not, but I'd probably ask to be retreated just in case, too. Keep me posted.
COMMUNITY LEADER
They might, if it's a new infection. Did he say when he wanted you to retest? I might wait a month, though I know that seems like a long time.
2 Comments
I retested for syphilis and titre again is 1:16. I have left a message for the doctor but he has already indicated that he is not concerned by 2 fold increase. But I have asked the doctor to reconsider a penicillin shot or doxycycline treatment in case of serofasting or resistant strain.
I was already treated once and titre came down 4 fold but increased 2 fold after 3 months. Unfortunately the criteria is for 4 fold increase and my increase does not meet the criteria. However I am strongly asking for re-treatment.
COMMUNITY LEADER
You don't mention if you've had any possible exposures since your treatment. If you have, it's possible this is a new infection. If you had sex with a prior partner who had not been treated, then for sure this could be a re-infection.
If you haven't, the doctor may well indeed wait until May to see what happens on that test.
What kind of syphilis test are they doing - an RPR? VDRL? FTA-ABS?
If you haven't, the doctor may well indeed wait until May to see what happens on that test.
What kind of syphilis test are they doing - an RPR? VDRL? FTA-ABS?
3 Comments
In Canada they do RPR for titres. The question is that isn't the criteria for reinfection a 4 fold increase. Mine is a 2 fold increase.
Yes I did have sex between my November and February tests.
FYI...got a call from the doctor saying 2 fold increase is not significant increase for either treatment failure or reinfection although he gave me another requisition for a repeat blood test to see whether titres increase decrease or stay the same for next course of action. Last test was on 12 Feb 2019 so would you say within 2 weeks the titres will change if they have to?
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Herpes spreads by oral, vaginal and anal sex.
Herpes sores blister, then burst, scab and heal.
STIs are the most common cause of genital sores.
Millions of people are diagnosed with STDs in the U.S. each year.
STDs can't be transmitted by casual contact, like hugging or touching.
Syphilis is an STD that is transmitted by oral, genital and anal sex.
