Why the reactionRWpositive? The daughter did not have sexually transmitted diseases, she has lived with her husband for 10 years, he was also checked. She cannot tolerate dairy, sweets, bread, potatoes... The mucous membranes of the nose and mouth become coated. The doctor prescribed strong antibiotics, but after themRWmoremore positive (4+). The attitude at the hospital is appropriate; no one wants to understand. We've been struggling for 10 years. Before her illness, my daughter worked in a bakery, and then she was first diagnosed with candidiasis. How can I help her?
Z.F., Smolensk region.
The questions are answered by a person who owns a large arsenal of methods of non-traditional and traditional medicine, natural therapist G.G. Garkusha.
Every person has donated blood from a vein at least once in their life, as indicated in the referral leaflet. What kind of analysis is this? The letters RW stand for "Wassermann reaction". A German immunologist was the first to propose such a method for diagnosing syphilis, and throughout the 20th century he used it.
To obtain results after donating blood for RW, additional time is required for the antibodies to make themselves felt. If the infection is primary, then the reaction is usually positive at 6-8 weeks in 90% of cases (++++). With the secondary manifestation of the disease, it’s almost the same. Positive RW can also serve as an indicator of the correctness of syphilis treatment. But in this case, the indicator, as a rule, decreases, that is, there are fewer advantages. Then they are completely gone. However, in approximately 5% of patients who have had syphilis, a positive reaction is observed even after special treatment. Moreover, it remains weakly positive until the end of life.
The advantage of this test is its simplicity. But there is also a serious drawback: it is possible to falsely positive result. In Russia, since the 80s of the 20th century, they have practically abandoned this method because it is outdated. There are also more reliable ones - microprecipitation reaction (MPR) and others.
The fact is that Wasserman reaction can be positive and lupus erythematosus, malaria, leptospirosis, ... The list goes on. Even during pregnancy and within 40 days after birth. Often positive results are observed with increased load to the liver. Anesthesia, certain medications and vaccinations, drinking alcohol on the eve of the test, abuse of coffee, foods with preservatives and trans fats can affect this. As you can see, there are many reasons, and additional checks are required. Therefore, it is better to conduct other additional tests that are usually used in diagnosing sexually transmitted diseases.
In any case, until the liver, the body’s filter, is thoroughly cleansed, RW can remain positive for a long time. Therefore, I advise your daughter to follow diet No. 5, and also cleanse the liver by any means - do dubazhi, take special drugs or herbs, especially bitter ones. I recommend wormwood, tansy, immortelle, yarrow, elecampane, lingonberry, and celandine. For 1 tbsp. l. herbs - 0.5 liters of boiling water. Drink the strained infusion hot, ½ cup before and after meals, 3-4 times a day. Alternate the named plants, brewing each for 21 days, from full moon to full moon.
As for mushrooms, it is very difficult to get rid of them. When immunity decreases, they begin to “eat” us from the inside, affecting, among other organs, the intestines. In the end - again
The purpose of a blood test for syphilis is to identify antibodies that the body could produce to fight its causative agent, Treponema pallidum.
False positive test syphilis may occur in cases where the production of antigens occurred for other reasons.
Why does a false positive reaction to syphilis occur?
False-positive syphilis is diagnosed in 10% of cases.
Since a test for syphilis is prescribed not only when a patient has complaints, but during a medical examination, before employment, during pregnancy, before hospitalization, there is a high percentage of infection in people who did not even suspect the presence of such a disease.
To eliminate errors, it is necessary to ensure the reliability of the results obtained.
Positive results for syphilis are divided into two groups: acute and chronic. An acute false-positive result occurs within 6 months of regular testing.
- acute infectious disorders;
- injuries;
- any vaccination 1-7 days before taking the sample;
- acute poisoning.
In the presence of any of the factors in the body, the process of antibody production is activated, which is reflected in the test results.
If there are chronic problems, the test may show erroneous results for 6 months or more.
- connective tissue disorders;
- any form of tuberculosis;
- chronic liver disorders;
- HIV, hepatitis B, C, D, and other viral diseases;
- autoimmune processes in the body.
The result becomes erroneous due to the systematic production of nonspecific antibodies in response to one of the listed disorders.
What to do if false syphilis is detected
To determine whether a test for syphilis may be erroneous, you need to evaluate the presence of other factors in the manifestation of the disease and the likelihood of infection.
Treponema pallidum is a pathogen that is sexually transmitted through the mucous membranes of the genitals, mouth and rectum upon contact with an infected person. Transmission from an infected mother to her child is also possible.
The incubation period during which the disease does not make itself felt is 2-6 weeks. After this, syphilitic ulcers with a dense base are formed at the sites of possible infection.
After 1-2 weeks, the lymph nodes closest to the site of the lesion enlarge and become painful.
When diagnosing false-positive syphilis, you must return to a medical facility. At the same time, inform about all the medications that you took on the eve of the test, chronic and acute diseases.
If you had unprotected sex with an untested partner or you discovered the first signs of the disease, you should tell your doctor about it.
After collecting an anamnesis and conducting an examination, the doctor will prescribe you a series of tests that will allow you to determine the exact result with an error of less than 1%.
Types of tests for syphilis
There are two types of tests: non-treponemal and treponemal. The first option involves the use of artificial analogues of Treponema pallidum; in the second case, real treponemes are used.
Non-treponemal methods
Such techniques are widespread and are most often used in routine medical examinations.
The advantage is low cost, quick results, and the ability to conduct research using standard laboratory equipment.
To carry it out, blood is taken from the patient, and less often, cerebrospinal fluid. Blood can be taken from a finger or a vein. The error in conducting such a study can be up to 7%.
Precipitation microreaction (MR or RMP)
May include two types of syphilis tests RPR and VDRL. As a result of cell breakdown under the influence of treponema, antilipid antibodies are formed.
Lipids can be destroyed under the influence of other disorders, so the degree of error when performing VDRL and RPR is 1-3%.
Treponemal tests
Such studies are not carried out in all clinics and require expensive equipment.
Therefore, they are used when the presence of the disease is suspected based on the results of non-treponemal tests. The error of such studies is less than 1%.
REEF
Allows you to determine antigens and antibodies. To determine the result, the patient donates blood from a finger or vein. As a result, testing also helps determine the stage of the disease.
RPGA
The RPGA test for syphilis allows you to determine the percentage of red blood cell adhesion. Accurate reaction result passive hemagglutination can be obtained on the 28th day after infection.
ELISA
Enzyme immunoassay determines the presence and stage of the disease based on the level of immunoglobulins of various types.
A positive syphilis ELISA allows you to determine the types of immunoglobulins that are formed after infection for 14 days, 14-28 days, more than 28 days.
PCR
The most accurate test to detect pathogenic DNA. It is used in rare cases, as it requires complex reagents.
The probability of error of the RIF, RPGA, ELISA tests is less than 1%. With PCR, the error can be 0-1%.
Positive result for syphilis in pregnant women
In pregnant women, an erroneous result can be observed in 1.5% of cases when performing non-treponemal tests. Analysis for this type of disease is mandatory throughout pregnancy.
The first test for syphilis is carried out at 12 weeks, then at 30 weeks and before birth. The result may be false due to natural changes in the body, and in particular, immunity to protect the growing fetus.
Therefore, during pregnancy, a repeat test may be prescribed; it is often prescribed even if the first results are negative, if there was a risk factor.
Treponemal tests may also be prescribed, since the effect of the disease on the child’s body is more destructive than antibiotic treatment if the diagnosis is confirmed.
Weak positive test
If the result form you receive contains 1-2 pluses, this may indicate the presence of a small amount of antibodies. These results can occur in several cases:
- unfinished incubation period;
- late form, after 2-4 years;
- residual antibodies after treatment of the disease.
In this case, a repeat check is required after 2 weeks.
How to properly prepare for tests
If an erroneous test for syphilis was performed, you will be given a repeat test. In order for its results to be as accurate as possible, it is necessary to prepare properly.
- Before the analysis, you are allowed to drink only water, eating is prohibited;
- give up alcohol and smoking 1 hour before 24 hours;
- if you are donating blood from a vein, spend 10 minutes at rest before doing so;
- if infectious diseases have worsened, menstruation is occurring, or the patient was exposed to X-ray exposure, a blood test for syphilis is not performed.
There are also a number of drugs on the list of contraindications, so if you are undergoing treatment, tell your doctor about the medications you are taking.
If the disease is confirmed
If, after carrying out several checks, including treponemal tests, the result is positive, it is worth taking a number of measures:
- inform your sexual partner about this, it is necessary that he also undergo examination;
- close relatives must undergo examination;
- it is necessary to carry out preventive treatment of loved ones;
- During the entire course of treatment, it is necessary to issue a sick leave certificate and avoid close contact with other people to avoid transmission of infection;
- Upon completion of treatment, a certificate is issued that must be attached to medical card and provide during antibody examinations so that diagnosticians do not have questions about the appearance of antigens in the results.
When making a diagnosis, information is confidential. It is not disclosed when taking sick leave; in all documents issued by the hospital, the name of the disease is encrypted; people who do not have close contact with the patient are not informed about this diagnosis.
After treatment, the patient is completely safe; having syphilis in the past cannot be a reason for denial of employment or the exercise of other human rights.
If the diagnosis is confirmed by early stages, then the probability of complete recovery is 100%. Treponema pallidum is one of the few, over many years of treating patients with penicillin, that has not developed protection against it.
Therefore, patients are treated with drugs based on penicillin derivatives. If the primary form of the disease occurs, it is necessary to diagnose and treat all sexual partners that the infected person had within 3 months.
Syphilis after treatment initial stage leaves no complications. The disease can lead to disability if it passes chronic course or there was an infection in the womb.
Timely detection of syphilis (using special analyzes) allows doctors to start treatment on time and prevent the development dangerous complications this disease.
Testing for syphilis during pregnancy helps prevent the birth of children with congenital syphilis. Testing for syphilis during pregnancy is described in detail in the article.
Why was I prescribed a test for syphilis?
In the vast majority of cases, doctors do not have the opportunity to obtain accurate data about the sex life of patients (some people hide details of their sex life or underestimate the risk of contracting sexually transmitted diseases). Therefore, in order to protect people from possible consequences due to their own carelessness or lack of medical knowledge, in some cases doctors prescribe so-called syphilis screening tests (that is, tests that are taken by large numbers of people).
Your doctor may order tests for syphilis even if you have no symptoms of the disease and are confident that you could not have contracted it.
The need for these tests is due to the fact that syphilis is sometimes transmitted through everyday contact (not through sexual contact) and occurs in a latent form (that is, without symptoms).
As a rule, a screening examination is prescribed in the following situations:
- When applying for a job (health care workers, catering workers, military personnel, etc.)
- When registering for pregnancy.
- During admission to the hospital, in preparation for operations.
- Blood donors.
- Persons imprisoned in places of deprivation of liberty.
Your doctor may also order tests for syphilis:
- When symptoms of the disease are detected (usually a rash in the genital area).
- Upon receiving positive results of screening tests for syphilis.
- If you have had sexual contact with a person who has been diagnosed with syphilis.
- Newborn children whose mothers have syphilis.
In addition, tests for syphilis are carried out periodically during treatment (to ensure that the treatment is effective) and even after the end of the course of treatment, to monitor cure.
What tests are used to diagnose syphilis?
A dermatovenerologist is involved in the diagnosis and treatment of syphilis. The following tests can be used to diagnose the disease:
Inspection skin, external and internal genital organs is performed in order to identify the main symptoms of syphilis: chancre, enlarged lymph nodes, skin rashes, etc. (see)
In order to detect Treponema pallidum, doctors examine smears (or scrapings) obtained from ulcers, lymph nodes, amniotic fluid in pregnant women, etc. under a microscope. Blood is not examined under a microscope.
Important: If Treponema pallidum was detected in your tests under a microscope, this means that you definitely have syphilis. But if tests show that the causative agent of syphilis has not been detected, you cannot be completely sure that there is no syphilis. To make sure you are not sick, you need to take additional tests described below.
PCR (polymerase chain reaction) is a complex and expensive method for diagnosing syphilis, which makes it possible to detect Treponema pallidum DNA in the blood or other test materials (amniotic fluid, cerebrospinal fluid). If the PCR analysis gave negative result, then most likely you do not have syphilis. However, if you receive a positive result (that is, if the PCR detected Treponema pallidum DNA in the blood), there is no 100% guarantee that you are sick. This is due to the fact that PCR sometimes gives false positive results (gives a positive result in the absence of the disease). Therefore, if PCR gives a positive result, it is recommended to additionally undergo other methods of examination for syphilis (for example, the immunofluorescence reaction (RIF) and the passive hemagglutination test (RPHA)).
What is a serological test for syphilis?
Serological analysis is the detection in the blood of special proteins (antibodies) that are produced in the human body in response to infection. Unlike previous diagnostic methods, serological tests do not detect Treponema pallidum itself, but only its “traces” in the body.
If antibodies to Treponema pallidum are found in your blood, this indicates that you are either infected with syphilis this moment, or have had it before.
What tests indicate that a person has syphilis?
Serological tests for syphilis are divided into 2 large groups: nonspecific and specific tests. The main difference between these tests is that nonspecific tests show a positive result only if a person currently has syphilis and become negative after treatment, while specific tests remain positive even after the disease is cured.
In other words, a negative nonspecific test result is some guarantee that you are healthy.
What tests for syphilis are nonspecific (non-treponemal)?
Nonspecific tests include the microprecipitation reaction (MR) and the Wasserman reaction (RW). These tests are used to screen for syphilis. After syphilis is cured, these tests become negative in 90% of people.
How these tests work: As a result of the vital activity of Treponema pallidum (with syphilis), cells in the body die. In response to cell destruction, the immune system produces special proteins (antibodies, or immunoglobulins). Nonspecific tests are aimed at identifying these antibodies, as well as calculating their concentration (determining antibody titer).
Precipitation microreaction (MR) and its analogues in some countries: rapid reagin test (RPR, Rapid Plasma Reagins) And VDRL test (Venereal Diseases Research Laboratory) are non-treponemal tests that are prescribed to screen for syphilis.
What will be examined:
usually 4-5 weeks after infection.
if the test shows a positive result, then there is a possibility that you have syphilis. Since this test may falsely give positive results, it is recommended that you undergo additional examination using specific tests described below. A negative result indicates the absence of syphilis, or an early stage of the disease (before the appearance of antibodies in the blood).
if antibodies are found in the blood in a titer of 1:2 to 1:320 or higher, this means that you are infected with syphilis. With late syphilis, the antibody titer may be low (which is assessed as a questionable result).
false positive MR results occur in approximately 2-5% of cases, here are them possible reasons:
- Systemic diseases connective tissue(systemic lupus erythematosus, scleroderma, rheumatoid arthritis, dermatomyositis, vasculitis, etc.)
- Infectious diseases: viral hepatitis, infectious mononucleosis, tuberculosis, some intestinal infections, etc.
- Inflammatory diseases heart (endocarditis, myocarditis).
- Diabetes .
- Pregnancy.
- Recent vaccination (vaccination).
- Use of alcohol, drugs, etc.
- Previously suffered and cured syphilis (in about 10% of people who have undergone treatment, the MR test may remain positive for life).
What could be the reasons for false negative results: the test may erroneously show a negative result if the blood contains a lot of antibodies, if the test is taken at an early stage of the disease before antibodies appear, or with late syphilis, when there are few antibodies left in the blood.
Wasserman reaction (RW, RW) is a non-treponemal test that is used to screen for syphilis in the CIS countries.
What will be examined: blood (from a finger or from a vein), cerebrospinal fluid.
How long after infection does the test become positive? usually 6-8 weeks after infection.
How to evaluate the analysis results:“-” is a negative reaction, “+” or “++” is a weakly positive reaction, “+++” is a positive reaction, “++++” is a strongly positive reaction. If the Wasserman reaction showed at least one plus, then you need to take additional tests for syphilis. A negative reaction is not a guarantee that you are healthy.
How to evaluate the resulting antibody titer: An antibody titer from 1:2 to 1:800 indicates the presence of syphilis.
What could be the reasons for false positive results: the Wasserman reaction may erroneously give a positive result for the same reasons as the microprecipitation reaction (MR), and also if, shortly before donating blood for analysis, you drank alcohol or consumed fatty foods.
Due to the large number erroneous results The Wasserman reaction (RW, RW) is used less and less and is being replaced by other, more reliable diagnostic methods.
Nonspecific tests (precipitation microreaction (MR) and Wasserman reaction (RW)) are good methods diagnosis of syphilis. A negative test result most likely indicates that you are healthy. But if positive results of these tests are obtained, additional examination is necessary using specific (treponemal) tests.
What tests for syphilis are specific (treponemal)?
Treponemal tests include the following tests: immunofluorescence reaction (RIF), immunoblotting, passive agglutination reaction (RPGA), pallidum treponema immobilization reaction (RIBT), linked immunosorbent assay(ELISA).
Specific tests are prescribed for people who have positive microprecipitation reaction (MR) or Wasserman reaction (WR) results. Specific tests remain positive for a long time after curing syphilis.
How these tests work: When syphilis pathogens enter the body, the immune system produces antibodies aimed at combating treponema pallidum. These antibodies do not appear in the blood immediately after infection, but only several weeks later. Around the end of the second week after infection, IgM antibodies appear in the blood. Antibodies of this class indicate recent infection with syphilis, but without treatment they remain in the blood for several months and even years (while their number gradually decreases). 4-5 weeks after infection with syphilis, antibodies of another class, IgG, begin to be detected in the blood. Antibodies of this type remain in the blood for many years (sometimes throughout life). Treponema tests can detect the presence of antibodies (IgM and IgG) in the blood aimed at combating Treponema pallidum.
Immunofluorescence reaction (RIF) or Fluorescent Treponemal Antibody (FTA, and its variant FTA-ABS) is a treponemal test that is used to confirm the diagnosis of syphilis in the earliest stages (even before the first symptoms appear).
What will be examined: blood from a vein or finger.
How long after infection does the test become positive?: usually after 6-9 weeks.
How to evaluate the analysis results: The analysis results are presented in the form of minus or pluses (from one to four). If the test shows a minus sign, it means no antibodies were detected and you are healthy. The presence of one plus or more indicates the presence of syphilis.
What could be the reasons for false positive results: False-positive results are rare, but errors are possible in people with connective tissue diseases (systemic lupus erythematosus, dermatomyositis, etc.), in pregnant women, etc.
Passive agglutination reaction (RPGA), or Treponema pallidum hemagglution assay (TPHA) is a specific test that is used to confirm the diagnosis of syphilis at almost any stage.
What is being examined?: blood from a vein or finger.
How long after infection does the test become positive? usually within 4 weeks.
How to evaluate the analysis results: a positive RPGA result indicates that you have syphilis, or are healthy, but have had this disease in the past.
How to evaluate the resulting antibody titer: Depending on the antibody titer, one can roughly assume the duration of infection with syphilis. Soon after the first entry of treponema into the body, the antibody titer is usually less than 1:320. The higher the antibody titer, the more time has passed since infection.
Enzyme-linked immunosorbent assay (ELISA), or Enzyme ImmunoAssay (EIA), or ELISA (Enzyme Linked ImmunoSorbent Assay) is a treponemal test that is used to confirm the diagnosis and determine the stage of syphilis.
What will be examined: blood from a vein or finger.
How long after infection does the test become positive? already 3 weeks after infection.
How to evaluate the analysis results: a positive ELISA result indicates that you have syphilis or have previously had this disease. This test may remain positive even after treatment.
Determining the duration of syphilis infection using ELISA: Depending on what classes of antibodies (IgA, IgM, IgG) are found in the blood, we can assume how long ago the infection was.
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What does this mean |
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Recent infection. Less than 2 weeks have passed since infection with syphilis. |
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Recent infection. Less than 4 weeks have passed since infection with syphilis. |
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More than 4 weeks have passed since the moment of infection with syphilis. |
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The infection was a long time ago, or syphilis was successfully treated. |
Treponema pallidum immobilization reaction (TPI) is a highly sensitive treponemal test that is used only in cases of questionable results of other serological tests, if false positive results are suspected (in pregnant women, people with connective tissue diseases, etc.) RIBT becomes positive only 12 weeks after infection.
Immunoblotting (Western Blot)– a highly sensitive treponemal test that is used in the diagnosis of congenital syphilis in newborns. This test is used when other tests give questionable results.
What do the results of serological tests for syphilis mean?
The diagnosis of syphilis is never made based on the results of one test, since there is always the possibility that the result was erroneous. In order to get an accurate diagnosis, doctors evaluate the results of several tests at once. Typically, this is one nonspecific test and two specific ones.
Most often, 3 serological tests are used in the diagnosis of syphilis: microprecipitation reaction (MR), immunofluorescence reaction (RIF) and passive hemagglutination reaction (RPHA). The above tests often give opposite results, so we will look at what different combinations of results mean:
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RPGA |
What does this mean |
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False-positive result of microprecipitation reaction (MR). Syphilis has not been confirmed. |
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Syphilis at an early stage (primary syphilis). It is also possible that MR and RIF gave false positive results. |
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Syphilis at any stage, or recently treated syphilis. |
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Syphilis at an early stage, or a false positive RIF result. |
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Long-term and cured syphilis, or a false positive result of RPGA. |
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Long-term and cured syphilis, or late syphilis. |
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The diagnosis of syphilis has not been confirmed, or the early stage of development of syphilis before antibodies appear in the blood. |
Diagnosis of syphilis: answers to frequently asked questions
1. I have never had symptoms of syphilis, but tests showed positive results. What to do?
First of all, you need to find out from your doctor exactly which tests showed a positive result for syphilis. If this is one of the screening tests (microprecipitation reaction (MR) or Wasserman reaction (RW, RW)), then it is possible that the results are false positive. In this case, it is recommended to undergo treponemal tests for syphilis (RIF, ELISA, RPGA). If they give a positive result, then you probably have latent syphilis, which is asymptomatic. You will be asked to undergo standard treatment for latent syphilis. (see Treatment of Syphilis)
If the treponemal tests give a negative result, then the screening tests were incorrect. In this case, it is recommended to consult a doctor who can help determine the cause of false positive results.
It is important to understand that the diagnosis of syphilis is not made by a positive result of one test. To clarify the diagnosis it is necessary full examination, the plan of which will be communicated by your attending physician.
2. Can I infect my partner if I test positive for syphilis?
If tests show that you have syphilis, you can infect your sexual partner. It is believed that with one single unprotected sexual contact with a person with syphilis, the risk of infection is about 30%. However, with regular sexual activity this risk is slightly higher.
Therefore, you need to inform your sexual partner that he may be infected with syphilis and that he needs to get tested.
It is important to understand that syphilis can long time occur in a hidden form, and if you do not inform your partner about the risk of infection, he may find out about the presence of this disease when complications develop, when it is too late.
3. Why are my test results for syphilis positive, but my partner’s test results are negative?
There are several possible reasons:
- Your partner has not contracted syphilis. The risk of transmitting syphilis during a single unprotected sexual encounter is about 30%. With regular unprotected sex life, this risk is 75-80%. Thus, some people may be immune to this infection and remain healthy even with regular contact with someone with syphilis.
- Your partner contracted syphilis, but this happened less than 3 months ago, and his body has not yet had time to produce antibodies indicating the presence of the disease.
Thus, if you have a confirmed diagnosis of syphilis, but your partner tests negative, it is recommended that he be tested again in a few months, or take a course of preventive treatment.
4. How long after a course of treatment can I be tested for syphilis again?
5. What test results for syphilis confirm complete cure and are grounds for deregistration?
To monitor the cure of syphilis, non-treponemal tests are used (which allow you to determine the titer of antibodies in the blood): microprecipitation reaction (MR) or Wasserman reaction (RW, RW).
Deregistration is subject to receipt of 3 negative test results carried out at an interval of 3 months (that is, this is possible no earlier than 9 months after the end of the course of treatment).
6. Why do test results remain positive after a full course of treatment for syphilis?
All treponemal tests, as a rule, remain positive after completing the full course of treatment for syphilis and recovery. Therefore, these tests are not used to monitor the cure of syphilis.
If, at the end of the course of treatment, non-treponemal tests (Wassermann reaction (RW) and/or microprecipitation reaction (MR)) remain positive, then it is necessary to determine the amount (titer) of antibodies in the blood for 12 months (donate blood for analysis every 3 months) . Based on changes in antibody titer, further tactics are determined:
If the antibody titer has decreased by 4 or more times during the year, then observation is continued for another 6 months. If the titer continues to decrease, then observation is again extended for 6 months. If, 2 years after the end of the course of treatment, test results continue to give questionable or weakly positive results, then they speak of seroresistant syphilis.
If the antibody titer does not decrease or decreases by less than 4 times during the year, then they also speak of seroresistant syphilis.
7. What is sulfur-resistant syphilis and how is it treated?
Seroresistant syphilis is a condition in which, after completing a full course of antibiotic treatment, tests for syphilis (mainly microprecipitation reaction (MP)) remain positive. There are 2 possible causes of syphilis seroresistance:
- The treatment did not help, and the causative agent of syphilis is still in the body, stimulating the production of antibodies. Treatment of syphilis may be ineffective in the following cases: late detection and initiation of treatment of syphilis, improper treatment, interruptions in the course of treatment, resistance of Treponema pallidum to antibiotics.
- The treatment helped, but due to disturbances in the immune system, antibodies against Treponema pallidum continue to be produced. The reasons for such violations are not yet known.
If seroresistance is detected, the doctor will first try to find out if Treponema pallidum is still in the body. To do this, the doctor may prescribe additional tests (for example, PCR, enzyme-linked immunosorbent assay (ELISA)). If it turns out that the first course of treatment did not help, and there are still syphilis pathogens in the body, then you will be prescribed repeat course treatment (usually with antibiotics from the penicillin group). If seroresistance is caused by disturbances in the functioning of the immune system, then additional treatment with antibiotics is pointless (since, in fact, syphilis has already been cured).
This type of laboratory research is by far the most common, informative and simple.
Blood on RW - what is it?
The abbreviation stands for: R - reaction, W - Wasserman. It is safe to say that every adult, without even knowing about the existence of this technique, has taken this test at least once in his life.
Donating blood to RW is mandatory for a number of citizens:
- people for registration in a medical institution (in a clinic or during hospitalization);
- drug addicts;
- people in direct contact with people with syphilis;
- medical workers;
- workers who have contact with food, especially those involved in their preparation;
- donors;
- long-term feverish patients (more than 1 month).
Why is there such a wide range of people who need periodic this study? The reason lies in the insidiousness of the disease and its specificity. In some cases, a person does not even suspect that he is infected, and, without having any signs of the disease for a long time, can infect a large number of those around you.
The essence of the Wasserman reaction
The action of this laboratory reaction is to detect antibodies to the causative agent of syphilis - Treponema pallidum. The fact is that when infected (most often through sexual contact or household contact), the human immune system is triggered, and in response to the penetration of a foreign biological agent, a large number of antibodies are released into the blood, aimed at fighting it. When conducting laboratory diagnostics a known antigen (cardiolipin) is injected, and if an antigen-antibody compound is formed in the patient's blood sample, it means that the patient is infected.
It is very important to pay attention to any deviations in health in a timely manner and consult a doctor. In addition, it must be remembered that real opportunity not only to maintain your health, but also to ensure the health of your loved ones - donate blood for RW. What this is and what rules exist for donating blood, we will consider further.
Rules for donating blood at RW
The analysis is carried out on the material venous blood. Only 10 ml is needed to make a diagnosis. Blood for RW must be donated strictly on an empty stomach; moreover, at least 12 hours before the planned test, you must avoid drinking strong tea and coffee, and stop taking medications and alcohol. It is advisable not to smoke.
How long blood is taken for RW depends on the workload of the laboratory where you took the test, but on average it takes 1-2 days. In emergency cases, express diagnosis or cito testing is possible - immediately and quickly.
Decoding analysis data
So, we figured out the main issue: blood on RW - what it is and how it is carried out. Now it is worthwhile to dwell in more detail on the data that the patient sees in the analysis form.
The result may be negative, positive, doubtful or weakly positive.
A negative output is indicated by a minus sign “-”. If a blood test comes back negative, this, unfortunately, does not exclude the presence of syphilis. It can be such in the primary and tertiary periods of the disease and with excessive hemolysis of erythrocytes. It should be remembered that if infected in the first 2.5 weeks, the result will most likely be negative, and in a quarter of patients this may be the case even after 6 weeks from the onset of the disease.
A positive result has a plus sign “+”, of which there may ultimately be several, and their number indicates the degree of probability of the presence of the disease:
- “+” - the reaction is doubtful;
- “++” - weakly positive reaction;
- “+++” - positive reaction;
- “++++” - the reaction is sharply positive.
In some cases, false positive results may occur, since RW blood does not always confirm HIV infection, but can also be detected in other diseases (tuberculosis, pneumonia, oncological diseases, viral hepatitis, diabetes mellitus and even during pregnancy, when the woman is not infected with this disease).
If you receive a result with one or two pluses, the analysis must be retaken.
Remember, correct interpretation of RW blood results is very important. Decryption must be carried out exclusively by a specialist! Only a doctor can competently compare complaints, anamnesis, clinical picture, objective data, results laboratory research and draw the right conclusion.
To confirm or remove the diagnosis of syphilis, additional laboratory diagnostic methods can be used: immunofluorescence reaction and immobilization of Treponema pallidum.
RIF (immunofluorescence reaction) involves detecting treponemes by adding them to human serum. The pathogen is isolated from a rabbit infected with syphilis, and if a glow occurs when these two media are mixed in a fluorescent microscope, the diagnosis is confirmed. If there is no glow, it means that there is no pathogen in the human body. This method is much more sensitive than the Wasserman reaction and can be used in the very early stages of the disease.
RIBT (treponema pallidum immobilization reaction) is a highly specific test that allows you to recognize a false positive result and differentiate a healthy person from a sick person.
Indications for use
A blood test for RW is prescribed for:
- planning pregnancy (at least three times during its course);
- unmotivated weakness and bone pain;
- accidental sexual intercourse (especially unprotected);
- copious discharge and ulcerations on the genitals;
- rashes on mucous membranes and skin;
- enlarged lymph nodes, especially if at least one of the above symptoms is present;
- medical examinations;
- before surgery.
Conclusion
It should be remembered when donating blood to RW that this is not a death sentence, but only an opportunity to identify an insidious enemy and begin the fight against him in time. Be careful and healthy!
The Wassermann test (RW) is the most popular immunological test used to diagnose syphilis since its discovery in 1906. RW belongs to the group of complement fixation reactions (FFR) and is based on the ability of the blood serum of a syphilis patient to form a complex with the corresponding antigens. Modern techniques RSCs used to diagnose syphilis differ significantly in their antigens from the classical Wassermann reaction, however, the term “Wassermann reaction” is traditionally reserved for them.
Antibodies produced by the immune system appear in the blood of an infected person. The causative agent of the disease, Treponema pallidum, contains the antigen cardiolipin, which causes the production of antibodies detected by RW. A positive Wasserman reaction indicates the presence of such antibodies in a person’s blood, and on this basis a conclusion is made about the presence of the disease.
The hemolysis reaction is an indicator of the result of the study in the RSC. The reaction involves two components: sheep red blood cells and hemolytic serum. Hemolytic serum is obtained by immunizing a rabbit with sheep red blood cells. It is inactivated for 30 minutes at a temperature of 56°C. The results of RSC are evaluated depending on the presence or absence of hemolysis in the test tubes. The presence of hemolysis is explained by the fact that if there are no syphilitic antibodies in the test serum, then the antigen-antibody reaction does not occur, and all the complement goes to the sheep erythrocyte-hemolysin reaction. And if there are specific antibodies, the complement is completely spent on the antigen-antibody reaction and hemolysis does not occur.
All ingredients for the Wasserman reaction are taken in the same volume - 0.5 or 0.25 ml. For strong fixation of complement on a specific complex, a mixture of the test serum, antigen and complement is placed in a thermostat at a temperature of 37° for 45-60 minutes. (phase I reaction), after which a hemolytic system consisting of sheep erythrocytes and hemolytic serum is added (phase II reaction). Next, the tubes are again placed in a thermostat for 30-60 minutes until hemolysis occurs in the control, in which the antigen is replaced with saline solution, and instead of the test serum, saline. Antigens for the Wasserman reaction are produced in finished form, indicating the titer and dilution method.
The maximum positivity of the Wasserman reaction is usually indicated by the number of crosses: ++++ (strongly positive reaction) - indicates a complete delay in hemolysis; +++ (positive reaction) - corresponds to a significant delay in hemolysis, ++ (weakly positive reaction) - evidence of a partial delay in hemolysis, + (doubtful reaction) - corresponds to a slight delay in hemolysis. Negative RW is characterized by complete hemolysis in all test tubes.
However, sometimes false positive results are possible - this is due to the fact that cardiolipin is also found in some quantities in the cells of the human body. The immune system does not create antibodies against a person’s “own” cardiolipin, but there are exceptions to this rule, due to which a positive Wasserman reaction occurs in a completely healthy person. This is especially often observed after severe viral and other diseases - pneumonia, malaria, liver and blood diseases, during pregnancy, i.e. in moments of severe weakening of the immune system.
If a doctor suspects a patient has a false positive result for the Wasserman reaction, he can prescribe a number of additional tests that are usually used in diagnosing sexually transmitted diseases.
Diseases and cases in which a doctor may prescribe a blood test for RW
Carrying out the procedure for taking a blood test for RW
Blood for RW is donated only on an empty stomach. The last meal should be no later than 6 hours before the test. The medical worker sits the patient down or places him on the couch and takes 8-10 ml of blood from the cubital vein.
If an analysis needs to be done on an infant, the sample is taken from the cranial or jugular vein.
Preparing for a blood test for RW
You should stop drinking alcohol 1-2 days before the test. It is also not recommended to eat fatty foods - they can distort the results. During the period of preparation for the analysis, you should refrain from taking digitalis medications.
Contraindications
The analysis result will be false if:
- the person is sick with an infectious disease or has just recovered from it,
- a woman is menstruating,
- pregnant in last weeks before childbirth,
- the first 10 days after birth,
- the first 10 days of a baby's life.
With primary syphilis, the Wasserman reaction becomes positive at 6-8 weeks of the disease (in 90% of cases), and the following dynamics are noted:
- in the first 15-17 days after infection, the reaction in most patients is usually negative;
- at the 5-6th week of the disease, in approximately 1/4 of the patients the reaction becomes positive;
- at the 7-8th week of the disease, RW becomes positive in the majority.
In secondary syphilis, RW is always positive. Together with others serological reactions(RPGA, ELISA, RIF) allows not only to detect the presence of the pathogen, but also to find out the approximate period of infection.
With the development of a syphilitic infection in the 4th week of the disease, after the onset of primary syphiloma, the Wasserman reaction passes from negative to positive, remaining so both in the secondary fresh and in the secondary recurrent period of syphilis. In the latent secondary period and without treatment, RW can turn negative so that when a clinical relapse of syphilis occurs, it becomes positive again. Therefore, in the latent period of syphilis, a negative Wasserman reaction does not indicate its absence or cure, but only serves as a favorable prognostic symptom.
With active lesions of the tertiary period of syphilis, positive RW occurs in approximately 3/4 of cases of the disease. When the active manifestations of the tertiary period of syphilis disappear, it often turns negative. In this case, a negative Wasserman reaction in patients does not indicate that they do not have a syphilitic infection.
In early congenital syphilis, RW is positive in almost all cases and is a valuable method for verifying the disease. In late congenital syphilis, its results correspond to those obtained in the tertiary period of acquired syphilis.
The study of the Wasserman reaction in the blood of patients with syphilis undergoing treatment is of great practical importance. In some patients, despite vigorous anti-syphilitic therapy, the Wasserman reaction does not turn negative - this is the so-called seroresistant syphilis. IN in this case It makes no sense to carry out endless antisyphilitic therapy, achieving the transition of positive RW to negative.
From the above it follows that a negative Wasserman reaction is not always a sign of the absence of a syphilitic infection in the body.
A positive Wasserman reaction is possible in people with a number of other diseases and conditions not related to syphilis:
All of the above indicates that a positive result of the Wasserman reaction is not yet unconditional evidence of the presence of a syphilitic infection.
Recovery after testing
After taking a blood test, doctors recommend the correct and balanced diet, as well as as much liquid as possible. You can afford warm tea and chocolate. It will be useful to refrain from physical activity and under no circumstances drink alcohol.
Norms
Normally, hemolysis should be observed in the blood - this is considered a negative reaction to syphilis (Wassermann reaction is negative). If hemolysis is absent, the degree of reaction is assessed, which depends on the stage of the disease (marked with “+” signs). At the same time, you should know that 3-5% have absolutely healthy people the reaction may be false positive. At the same time, in the first 15-17 days after infection, the reaction in sick people may be false negative.
