Indian J Sex Transm Dis Indian J Sex Transm Dis
Official Publication of the Indian Association for the Study of Sexually Transmitted Diseases
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Seroprevalence of syphilis by VDRL test and biological false positive reactions in different patient populations: Is it alarming? Our experience from a tertiary care center in India

 Department of Microbiology, Maulana Azad Medical College, Delhi University, New Delhi, India

Correspondence Address:
Preena Bhalla,
Department of Microbiology, Maulana Azad Medical College, Delhi University, New Delhi
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Source of Support: None, Conflict of Interest: None

DOI: 10.4103/0253-7184.194317

Introduction: Many centers for sexually transmitted infections in India perform only a single screening assay for diagnosis of syphilis which may yield biological false positive (BFP) reactions. Aims and Objective: The aim of this study was to determine the true picture of seroprevalence of syphilis and BFP reactions in different patient groups. Materials and Methods: A total of 57,308 serial serum samples obtained over a period of 5 years from different patient groups were screened by venereal disease research laboratory (VDRL) test both qualitatively and quantitatively. VDRL reactive sera were confirmed by Treponema pallidum hemagglutination (TPHA) test. Results: The overall seroprevalence of syphilis by VDRL test was 1.27%, and BFP rate in test population was 0.14%. The rate of BFP reactions among total tested male (0.44%) and female (0.1%) patients differs significantly. Out of 733 VDRL reactive samples, 81 were BFP, i.e., BFP reaction is occurring at a frequency of 11% of the total VDRL reactive samples (ratio of 8:1 for true positives/BFP). Similarly, among antenatal cases, almost 24% of the total VDRL reactive samples were BFP, or for every 116 true positives, there were 37 (almost one-third) BFP. Conclusion: Although the overall seroprevalence of syphilis is low; the frequency of occurrence of BFP reactions is quite alarming. Hence, treponemal test must be used for confirmation of VDRL reactive sera.

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    -  Patwardhan VV
    -  Bhattar S
    -  Bhalla P
    -  Rawat D
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