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What Do These VDRL Titre Levels Indicate?

Posted on Thu, 15 Dec 2016

Question: Hi doc, 13 months ago I suffered syphilis with VDrL 1:32 and after I eat the medicine the titres fall to 1:16, now I have a VDRL test again and the result is TPHA 1:8 and VDRL 1: 1.280, need your explaination and suggestion about this, thx

Answered by Dr. Dr. Kakkar (1 hour later)

Brief Answer:
Need more information

Detailed Answer:
Hello. Thank you for writing to us

I am dr.kakkar(dermatologist). I have noted your concern.

Since vdrl titres are used for monitoring response to treatment therefore a rise in vdrl titres after treatment could be either due to possible neurosyphilis, re-infection or co-infection with HIV. Another cause be inadequate treatment.

I would like to know which drug you were treated with? Was it an oral drug? Were you also screened for HIV?

Regards

Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar

Follow up: Dr. Dr. Kakkar (38 minutes later)

Docter sorry I give you wrong data, the data said that VDRL 1:8 and TPHA 1:1.280

Answered by Dr. Dr. Kakkar (13 hours later)

Brief Answer:
Falling vdrl titres indicates response to treatment

Detailed Answer:
Hi.

Since your vdrl titres have consistently fallen after treatment (4 fold fall within an year of treatment) therefore that indicates adequate response to treatment. TPHA titres are not used to monitor response to treatment. Tpha may remain positive throughout life whereas vdrl may become negative long after treatment.

Regards

Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar

Follow up: Dr. Dr. Kakkar (2 hours later)

Thx doc for the respon, so by this result, must I still consume the additional medicine to make the vdrl negative? And how about the tpha is being higher than before, is it mean something?

Answered by Dr. Dr. Kakkar (20 hours later)

Brief Answer:
No need for further treatment

Detailed Answer:
Hi.

No. There is no need for additional medication. VDRL would not fall any faster with additional medication.
As i already said TPHA stays positive for life and is not useful for monitoring response to treatment. Titres of TPHA may vary depending on the type of test kit used and is nothing to worry. A higher TPHA titre than earlier does nt indicate treatment failure as long as VDRL is falling.

Regards

Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar

Follow up: Dr. Dr. Kakkar (2 minutes later)

Thx doc, one more question. With this condition, can I have a sex with my wife without condom? Thx

Answered by Dr. Dr. Kakkar (59 minutes later)

Brief Answer:
Your wife should also at least screen for syphilis

Detailed Answer:
Hi.

Before that i would suggest that your wife also get screened for syphilis with a vdrl test for any possibility of past syphilis infection from unprotected sex with you prior to your treatment for syphilis.
Ideally if she was your regular sexual partner before you contracted syphilis then she should have also been treated for syphilis the same way as you.

Regards

Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar

Follow up: Dr. Dr. Kakkar (8 hours later)

Yes doc, she has run the syphilis test after I detected last yearand the result was clean. Then back to my last question, do I need to use the condom? Thx

Answered by Dr. Dr. Kakkar (30 minutes later)

Brief Answer:
Can avoid condom

Detailed Answer:
Hi.

If she was screened "negative" then you can safely practice unprotected intercourse with wife.

Regards

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Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar