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Syphilis Test
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The STD Forum is intended only for questions and support pertaining to sexually transmitted diseases other than HIV/AIDS, including chlamydia, gonorrhea, syphilis, human papillomavirus, genital warts, trichomonas, other vaginal infections, nongonoccal urethritis (NGU), cervicitis, molluscum contagiosum, chancroid, and pelvic inflammatory disease (PID). All questions will be answered by H. Hunter Handsfield, M.D. or Edward W Hook, MD.

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Syphilis Test

I had an STD screening done last week and my RPR came back reactive and the RPR TITER was 1:2, but the FTA-ABS test came back non-reactive (negative). The doctor mentioned that a titer of 1:2 was high and my internet research says that value is borderline. I am confused. He has order one more confirmatory test ( TP-PA ??).  Does FTA-ABS negative mean that the the RPR is false positive. what could be the reasons that RPR came positive ? could I have Syphilis ?  I am a 35 year old male with no major sickness or illness history. Should I repeat the test after some time ?

I have no visual symptoms of Syphills. Ocassionally, I do get some dry skin on my penis head which goes away when washed or a cream is used. No sores or blisters or anything of that sort.

Also, on the Herpes test, the test - HSV2 IGG HERPESELECT AB - it came back negative (0.07). Does it test both HSV 1 and HSV2 since it explicitly says HSV2. The description of the test however says "This assay is type specific and will differentiate between HSV-1 and HSV-2 infections".

Please advise.

Thanks in advance.
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239123_tn?1267651214
You have had a "biologic false positive" test result.   BFPs have been recognized for at least 60 years and are very common; that's why a second, confirmatory test is always done.  The negative FTA-ABS shows you don't have syphilis.  Your doc is being conservative in checking it out with a second confirmatory test result, the TPPA.  That's smart, but the odds are it also will be negative.  If so, you can be absolutely certain you have a BFP RPR and do not have syphilis and never had it in the past.

BFPs are more common in women than men (you don't say your sex).  They are especially common during pregnancy.  Once in a while, BFPs occur with systemic inflammatory disease, especially systemic lupus erythematosis (SLE).  But if you are asymptomatic and otherwise healthy, you have nothing to worry about.

HerpeSelect is offered in both HSV1 and HSV2 versions.  For whatever reason, it looks like the lab did only the HSV2 test; most likely your provider did not request the HSV1 component.  Your result says nothing about HSV1.

All in all, it sounds like you have a knowledgeable doc.  S/He knows about BFP and how to use confirmatory syphilis tests, and knows and to not order an HSV1 test when it isn't necessary.  Since half the population has positive HSV1 results and most of those have no problem with it, it is a smart move to just disregard HSV1 when sceening people for STD.  That's what we do in my STD clinic:  HSV2 only, with HSV1 only in special circumstances.

It appears that all is well, but if continued questions, follow up with your doc.  You're in good hands.  Good luck--

HHH, MD
-5 Comments
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Avatar_n_tn
Thanks doctor for your detailed reponse. I am a male and am 35 years old. I had mentioned it in my initial posting. Guess you missed it :-)

My only concern at this point is that does the dryness of skin and flaking occassionaly have anything to do with HCV 1 virus and does those symptoms warrant a HCV 1 test. I am an uncut male.

Thanks again.
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Avatar_n_tn
Dryness only on the head of the penis and not in any other parts of the body.
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239123_tn?1267651214
Sorry; I saw 35 years old but spaced on "male".

The symptoms you describe do not hint at HSV1 of either type.  Ask your doc and folliow his or her advice about whether HSV1 testing is warranted.  I see no reason for it.
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Avatar_n_tn
Thank you very much.

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