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Syphilis tests
Hi,
My friend yesterday finished his doxycycline treatment for syphilis. He tested again today and the RPR test came back positive with a titre of 1:2. This is the same titre as he had when he first discovered the infection (it was confirmed at the time by a second tpha test)
Does the fact that the titre hasn't changed mean the treatment didn't work? Is there any other test that can be performed to confirm the infection has been killed off? How long is it topical for the test to remain positive? Should he continue to abstain from sexual activity?
Thank you.
My friend yesterday finished his doxycycline treatment for syphilis. He tested again today and the RPR test came back positive with a titre of 1:2. This is the same titre as he had when he first discovered the infection (it was confirmed at the time by a second tpha test)
Does the fact that the titre hasn't changed mean the treatment didn't work? Is there any other test that can be performed to confirm the infection has been killed off? How long is it topical for the test to remain positive? Should he continue to abstain from sexual activity?
Thank you.
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It may be too soon to test to see any real change. It's not recommended to retest until 3 months after treatment.
Does he know when he was infected? How long was he treated for - did he get treated once, or a series of 3?
Did he get another confirmatory test? What did that say?
Does he know when he was infected? How long was he treated for - did he get treated once, or a series of 3?
Did he get another confirmatory test? What did that say?
8 Comments
Yes, he knows when he got infected. It was about 3/4 weeks before he tested positive. So the infection was definitely new.
He got a course of 10 days of doxycycline. That's it for now. That's all the doctor recommended.
He did get a confirmatory test. After the first positive RPR test, he got a TPHA test which was also positive, so he definitely had an active infection.
He got a course of 10 days of doxycycline. That's it for now. That's all the doctor recommended.
He did get a confirmatory test. After the first positive RPR test, he got a TPHA test which was also positive, so he definitely had an active infection.
Ohh yeah, 10 days of doxy probably didn't cure him. The recommended course of doxy is 500 mgs twice a day for 14 days.
The preferred treatment is penicillin shots, but if someone is allergic to that, they use doxy.
I meant after he treated and tested, did he get a confirmatory test?
I'd wait at least a few weeks and test again, but I'd consider him still contagious since he didn't get a full dose of treatment.
The preferred treatment is penicillin shots, but if someone is allergic to that, they use doxy.
I meant after he treated and tested, did he get a confirmatory test?
I'd wait at least a few weeks and test again, but I'd consider him still contagious since he didn't get a full dose of treatment.
He did get two does per day. His infection was very new. Not even stage two yet. I did find some other sites that mentioned treatment protocols with 100mg tablets which is what he got. I am worried about the fact that the doctor prescribed only 10 days.. Not really sure why.
My question was more related to how to interpret the titre parameter of the test result. From my understanding 1:2 is a very low titre. The fact that it has remained stable is good or bad? If the treatment was unsuccessful, wouldn't the titre become higher? The chances of the test becoming negative immediately after treatment was non existent anyway, right?
My question was more related to how to interpret the titre parameter of the test result. From my understanding 1:2 is a very low titre. The fact that it has remained stable is good or bad? If the treatment was unsuccessful, wouldn't the titre become higher? The chances of the test becoming negative immediately after treatment was non existent anyway, right?
Syphilis testing and serology is incredible difficult to understand even some experts have trouble.
I’ll try to help further, but your friend needs to talk to his doctor, or better yet maybe a separate doctor who specialises in STI. It’s clear the one he’s using now dosnt.
Are you the same person I helped before? If so:
It’s too early to say if treatment worked. He took AZ too yes @ what dosage ? A 2g dose may have been useful too.
10 days of doxycycline is too short of a corse than is recommended but you are right his titre of 1:2 is on the low side and is early syphilis, so while not recommended and no studies that I can see on it. 10 days may not be entirely useless and may work.
So if we combine chance that 2g az and 10 days doxy may work we do have a better than average chance he’s cured: frustrating that he wasn’t treated right to be sure but here we are.
It’s too early to see a serological response so I wouldn’t worry about that.
I’d talk or get him to talk to a doctor who knows about STI, please do that! They will know the local rate of Az resistance and will be able to inform next steps better.
Good luck
I’ll try to help further, but your friend needs to talk to his doctor, or better yet maybe a separate doctor who specialises in STI. It’s clear the one he’s using now dosnt.
Are you the same person I helped before? If so:
It’s too early to say if treatment worked. He took AZ too yes @ what dosage ? A 2g dose may have been useful too.
10 days of doxycycline is too short of a corse than is recommended but you are right his titre of 1:2 is on the low side and is early syphilis, so while not recommended and no studies that I can see on it. 10 days may not be entirely useless and may work.
So if we combine chance that 2g az and 10 days doxy may work we do have a better than average chance he’s cured: frustrating that he wasn’t treated right to be sure but here we are.
It’s too early to see a serological response so I wouldn’t worry about that.
I’d talk or get him to talk to a doctor who knows about STI, please do that! They will know the local rate of Az resistance and will be able to inform next steps better.
Good luck
Thank you very much for the information. Yes, I am the same person that you advised before, with the Az as part of the treatment.
The doctor he went to is an urologist, who works at a clinic that specifically mentions STIs on their website. It seemed like an OK clinic, and they advertise this as part of their expertise.
We are from Romania. Maybe Az resistance is not as high here? I don't know.
The doctor he went to is an urologist, who works at a clinic that specifically mentions STIs on their website. It seemed like an OK clinic, and they advertise this as part of their expertise.
We are from Romania. Maybe Az resistance is not as high here? I don't know.
The World Health Organization recommends penicillin, too, but I did find an article from 2017 that says Romania has a shortage of the type of penicillin needed.
2gm AZ with doxy should do it, but make sure he knows to return for testing in 3 and 6 months.
2gm AZ with doxy should do it, but make sure he knows to return for testing in 3 and 6 months.
auntiejessi, thank you for the information. That's the course he was prescribed and followed.
And definitely he'll get tested to make sure he turns negative eventually.
And definitely he'll get tested to make sure he turns negative eventually.
Good, let us know how it goes. :)
Good luck to you both.
Good luck to you both.
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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.
