Biological False Positive Reactors Research Articles

Syphilis serology in human immunodeficiency virus infection: evidence for false-negative fluorescent treponemal testing.

Injection drug users were assessed serologically for human immunodeficiency virus infection and syphilis every 6 months. Treatment histories were reviewed for any high-titer biologic false-positive (BFP) reactors, that is, persons with rapid plasma reagin (RPR) titers > or = 1:4 and negative results for fluorescent treponemal antibody absorption (FTA-ABS) tests. Selected sera were analyzed further by immunoblotting for the presence of antibodies reactive with specific Treponema pallidum antigens. Of 112 BFP reactors, 35 (31%) had at least one RPR test reactive at a dilution >1:8 while the FTA-ABS test remained nonreactive. Five reactors (4.5%) converted from nonreactive to reactive by FTA-ABS test; 4 (3.6%) were reactive by FTA-ABS tests but later became nonreactive. Antibodies to T. pallidum membrane antigens were detected in some samples that were persistently nonreactive by FTA-ABS test. Serologic patterns over time, along with very high-titer BFP reactions and reactivity with T. pallidum-specific antigens, suggest that some BFP reactions may represent FTA-negative syphilis.

Biological false positive serological tests for syphilis in the Jamaican population.

A total of 19,067 sera were screened for biological false positive (BFP) reactivity by the Venereal Disease Research Laboratory (VDRL) test. Sera which were reactive in the VDRL test were confirmed by the fluorescent treponemal antibody absorption (FTA-ABS) test. BFP reactions were detected in 0.59% of the general population, 0.72% of pregnant women and 11.8% of patients with systemic lupus erythematosus (SLE). The rate of BFP reactors among pregnant women did not differ significantly from the general population. The female to male ratio of BFP in the general population was 2:1 whilst that in the group of patients with SLE was 8:1. The overall seroprevalence of syphilis was 2.2%.

Serological tests for syphilis in Saudi Arabia.

A total of 6684 sera were initially screened for syphilis by the Venereal Disease Research Laboratory (VDRL) test and the Treponema pallidum haemagglutination assay (TPHA). Reactive sera from either or both these tests were tested for confirmation by the fluorescent treponemal antibody-absorbed (FTA-ABS) test. VDRL biological false positive reactors were detected in 0.5% of the total sera examined, with 0.4% and 0.8%, respectively, obtained in pregnant women and blood donors. Eight sera (0.1%) were found to be positive in the TPHA test alone. An overall positivity of 2.7% for syphilis was detected, with a 0.85% positivity in antenatal patients. Infection with T pallidum seemed to be more common in men than in women (1.6:1) and predominated in the age group 20-39 years. Serological testing of sera from 26 mother and infant pairs allowed one case of congenital syphilis to be detected by FTA-ABS (IgM) and identified VDRL biological false positivity in seven infants.

Posttreatment serological response of biologic false-positive reactors

Posttreatment serological response of biologic false-positive reactors

Counterimmunoelectrophoresis of Reiter Treponeme Axial filaments as a diagnostic test for syphilis

Purified axial filaments from the cultivable Reiter treponeme, previously shown to share an antigenic component with pathogenic Treponemia pallidum, were evaluated as antigen in a diagnostic test for syphilis. Antibody to the filaments was revealed by counterimmunoelectrophoresis. Conditions that produced optimal results in the test were established. A total of 343 sera from normal individuals, biological false-positive reactors, and from patients in the different stages of syphilis were subjected to the test. The results indicate the test to be sensitive and highly specific for detecting treponemal antibodies in human syphilis.

Acute and chronic biological false positive reactors to serological tests for syphilis. ABO blood groups and other investigations.

Acute and chronic biological false positive reactors to serological tests for syphilis. ABO blood groups and other investigations.

Syphilis and biologic false positive reactors among leprosy patients

Syphilis and biologic false positive reactors among leprosy patients

IMMUNOGLOBULINS IN SYPHILIS

Serum-immunoglobulin levels of fiftyfive patients with untreated syphilis were compared with those of thirty-one controls. Both IgM and IgG globulin were raised in primary, secondary, and latent syphilis. IgA was raised at the secondary stage. No associations were found between Venereal Disease Research Laboratory (V.D.R.L.) titres and concentrations of immunoglobulins. The V.D.R.L. titre of most syphilitic sera was not reduced by treatment with mercaptoethanol. Conversely, that of most chronic biological false-positive reactors was reduced by mercaptoethanol. But there were too many exceptions in both groups to make this a reliable diagnostic test.

The Biological False-Positive Phenomenon in Elderly Men

Of 259 predominately elderly male patients, with a positive serologic test for syphilis, 162 had negative Treponema Pallidum Immobilization tests and were therefore biological false-positive (BFP) reactors. This represents a prevalence of BFP reactions which is 65 times greater than that found in the general population. There was no increased prevalence of collagen-vascular disease among elderly male BFP reactors. Venereal history was not helpful in differentiating the syphilitic from the BFP reactor. The physician was unable to differentiate accurately the latent luetic from the BFP reactor without aid of a specific treponemal antigen test.

Auto-immune disease and the chronic biologic false-positive test for syphilis.

A significant percentage of persons who react positively to serological tests for syphilis (STS) do not have syphilis but are referred to as chronic biologic false-positive (BFP) reactors. The author studied 192 BFP reactors. Most of them were apparently healthy and had submitted to the STS in the course of premarital, prenatal, or preemployment examinations, but others had various diseases, including two cases of systemic lupus erythematosus (SLE). The clinical course of these BFP reactors has been significant, since the group includes 14 who now have SLE and 3 who have since developed Hashimoto's thyroiditis. The marked predominance of women in this series of BFP reactors was not explained by any discernible bias in the sample.

Serological tests in 150 cases of leprosy.

Hansen's disease is considered to be one of the well-known infections which upset serological tests for syphilis in patients in whom there has been no past or current treponemal infection. The reason why lepers are biological false positive (B.F.P.) reactors and why this failure in the specificity of lipoidal reactions occurs remains obscure. The frequency of false positive reactions is said to be greater in the lepromatous than in the tuberculoid or dimorphous forms of the disease. Examination of sera from lepers by the treponemal immobilization test (T.P.I.), which is the most specific test available, has lent weight to the criticism of the classical tests. Nelson (1953) studied the sera of 75 patients from the leper colony of Carville, in whom there was no past history and no clinical signs of syphilis, and found that 75 per cent. of the sera gave positive reactions for reagin but that only 16 per cent. were T.P.I. positive. The percentage of positive T.P.I. tests corresponded exactly with the frequency of syphilis in the population under consideration and Nelson concluded that almost 60 per cent. of these lepers were biological false positive reactors. Nelson's conclusions are shared by numerous workers in France and elsewhere. Such a lack of specificity of the classical tests for syphilis in lepers is, however, surprising if one considers the remarkable specificity and the high degree of sensitivity of these reactions in large groups of the population. It is for this reason that we have undertaken a systematic study of the serological reactions of the patients with leprosy in the Institut Marchoux de Bamako. Methods Sera were collected with sterile precautions at the Institut Marchoux; some were examined on the spot by the Kolmer, Kline, and V.D.R.L. tests and the rest were placed in ampoules and transported to Paris, where they

Treponemal Tests in Diagnosis of Syphilis and Biologic False Positive Reactors

Treponemal Tests in Diagnosis of Syphilis and Biologic False Positive Reactors

The natural history of systemic lupus erythematosus: An approach to its study through chronic biologic false positive reactors: Interim report

The natural history of systemic lupus erythematosus: An approach to its study through chronic biologic false positive reactors: Interim report

Systemic lupus erythematosus: recent advances in its diagnosis and treatment.

Excerpt During the last six years the author has had the opportunity personally to study and treat 175 patients with systemic lupus erythematosus. The purpose of this paper is to review the current...

The natural history of systemic lupus erythematosus: An approach to its study through chronic biologic false positive reactors

The natural history of systemic lupus erythematosus: An approach to its study through chronic biologic false positive reactors