Sensitivity of Eia syphilis test

Can you tell me the sensitivity and accuracy of the Eia syphilis enzyme immunoassay that measures the Igm and IgG antibodies specific for Treponema pallidium in latent and late stage syphilis? The timeline of possible infection would be 15 yrs. I've read that the sensitivity of this test goes down after this amount of time and in those stages. Is that true?

[H. Hunter Handsfield, M.D.]

The nonspecific serological tests (VDRL, RPR) become progressively less strong over the years and sometimes become entirely negative, even without treatment.  But all the syphilis specific tests, including the older ones like FTA-ABS and the newer EIA tests, remain positive for life.  Once in a while the FTA-ABS becomes negative if the patient's syphilis is detected and treated early, and the same might be true for the EIAs; research is needed on this aspect.  However, once positive in an untreated patient, the test is believed to remain positive for life.  A negative result is strong evidence that the person tested never had syphilis.  At the very least, a negative result proves that the person does not currently have active syphilis and has no potential for future reactivation.

I hope this helps.  Best wishes--  HHH, MD

[cdn067]

Sorry, I may have worded my question poorly, what am asking is if  the EIA test is a reliable and sensitive test after 15 years if hypothetically you were untreated? No chance of false negatives?

[H. Hunter Handsfield, M.D.]

Yes, that's what I said.  Re-read the last 2 sentences of my reply.  If the person in question is you and you have a negative syphilis EIA, you never had syphilis.