Brief Answer:
Both you and your partner should be treated for syphilis

Detailed Answer:
hello. thank you for writing to us.

i have taken note of your query and i have understood it.

Tpha is a specific test for syphilis. A positive Tpha test indicates either past or recent syphilis infection.

This test remains positive for lifetime of an individual once infected with syphilis & remains so even after adequate treatment for syphilis though the titres may fall over a period of time.

I assume you have never got treated for syphilis, and the fact that you are infected has come to light through this test.

Since it cannot be known the length of time you have been infected with syphilis, therefore, the best course of action would be to treat for late latent syphilis i.e weekly injections of Benzathine penicillin G for 3 weeks.
Both you and your partner should be treated the same way.

Once adequtely treated you can plan your pregnancy.

regards

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Brief Answer:
I suggest weekly Benzathine penicillin G injection

Detailed Answer:
Hi.

I apologize for some delay in my reply.

Benzathine penicillin G (BPG) is the recommended first-line agent for treatment of syphilis (in the primary, secondary, and early latent stages).

Doxycycline is an alternative/ second line treatment for syphilis but it is given for 4 weeks rather than 12 weeks in latent stages
Even though you have been treated with doxycycline in past I still suggest re-treatment with Benzathine penicillin.
The reason being that Benzathine Penicillin G is the only recommended therapy in patients in whom adequate treatment/ satisfactory response to treatment for syphilis cannot be assured, particularly if patient was initially treated with a second line drug i.e patients in whom VDRL becomes reactive again after it became non-reactive once Or in whom VDRl titres either don't fall Or increase.

I want to rule out any history of extramarital sexual contact and re-infection in you? Is there any history of extra-marital sexual contact?

I also suggest you to get VDRL titres done. Though in latent stages of syphilis VDRL titres are generally low e.g either 1:2 or 1:4..
However, VDRL tites if detected high can be used to monitor response to treatment. They should fall 4 fold every 3 months after treatment.
Moreover, if the VDRL titres are detected high (i.e anywhere above 1:8) that also indicates re-treatment with Benzathine penicillin.

Regards

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