What is Syphilis Serology?

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  • Written By: Dulce Corazon
  • Edited By: W. Everett
  • Last Modified Date: 26 September 2019
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Serology is a blood test often done to identify antibodies in the patient's blood serum and confirm the presence of infection. Syphilis is one of the infectious diseases that can be transmitted sexually, although it can also be transmitted through blood transfusion and from infected mother to fetus. The organism involved is the Treponema pallidum, which can penetrate broken skin and mucous membranes that come in contact with it. When the organism enters the body, the immune system often releases specific antibodies into the blood to fight off the infection. Syphilis serology, therefore is a diagnostic test that can detect the presence of antibodies against syphilis in a person suspected of having the disease.

Patients with syphilis usually develop lesions in the genital tract, which is often followed by non-specific symptoms like fever, headache, rashes, and joint pains. Most of these patients have a history of sexual intercourse. When doctors suspect a syphilis infection in patients, they may request a syphilis serology test to help in the diagnosis. An adequate amount of blood is then extracted from the patient's arm vein and processed in the laboratory for a syphilis serology test.


A variety of tests can be used to detect syphilis serolgy. The most common test for syphilis is therRapid plasma reagin (RPR) test, which is commonly performed as a screening test for syphilis and in monitoring patients' response to treatment. When this test is positive, another test, the fluorescent treponemal antibody absorption test may also be performed for further confirmation. Patients with active infections, as well as those with healed diseases, often have positive results with this test. On the other hand, the RPR test usually becomes negative when the infection has been treated.

These syphilis serology tests may not show positive results during the very early stage of infection or during the incubation period of the organism. There are also some individuals who do not have syphilis but may get positive results in the syphilis serology test. These are called false positive results and are often due to other diseases such as chicken pox, tuberculosis, leprosy, and rheumatoid arthritis, among many others. Pregnancy and heroin use can also cause positive results.

Physicians also may order syphilis serology tests for pregnant women and people being screened blood for transfusions. These are usually done to prevent infected mothers from infecting their child and to prevent blood donors from giving infected blood to patients who need blood transfusions. Couples planning on getting married may also get a syphilis serology test to ensure the health of each partner.


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Post 3

@burcinc-- I agree with everything @turkay1 mentioned. And it is not likely for a clinic to rely on one single serology to confirm that someone is syphilis negative or positive.

There are many different serologies used-- TPHA, VDRL, EIA and others. And clinics will run at least two of them and sometimes three or four to confirm results. So I agree that the risk of false negatives is unlikely unless there is another type of infection or health condition going on like the article described.

I'm not sure if it's good to make generalizations, but from what I know, the risk of spyhilis is pretty low in areas with low HIV infections and even lower in heterosexual relationships. So if you don't have HIV or syphilis symptoms and your serology comes back negative, you don't have syphilis!

Post 2

@burcinc-- As far as I know, for conclusive results, the person has to have STD testing at least four weeks after potential infection and that applies for the EIA syphilis serology test as well.

Some people choose to wait longer because the results are extremely dependable, say at three months. So it leaves no room for doubt. But generally, people can be confident with the results they receive after four weeks.

And EIA is one of the newest serology methods and one of the most dependable. I, at one point, had become obsessive about my test results and convinced myself that I had a false negative. But my doctor told me that older tests like RPR were not as dependable, but false negatives are not an issue with EIA. So tell your friend to be confident with the results he receives.

Post 1

If a syphilis serology comes up negative early on in the infection, at what time is the serology test conclusive then?

Someone I know wanted to get tested for it three weeks after potential infection but was told by the clinic to wait at least several more weeks.

From what I understand, different STD blood tests have different time frames for conclusive results. Some say around five weeks after infection, others even go as far as saying three months.

I believe my friend is planning to go for a syphilis serology called enzyme immunoassay (EIA) test. How long does he need to wait for conclusive results with this test?

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