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False positive syphillis test

Hello, I am a little anxious as I tested for all stds a few weeks ago and came back with a reactive rpr test for syphillis.  Rpr quantity was 1:1 but came back non reactive on trep palladium antibodies.  I have had hsv2 for several years and did have a pretty bad breakout at the time I tested.  I am wondering if this may of caused the false positive?  Or if it is an infection that is too recent to detect antibodies yet?  My doctor swabbed lesions that were confirmed as hsv2 nothing else.
If anyone could shed some light on if the breakout would cause this or what else can be a cause of false positive results i would appreciate it
1 Responses
207091 tn?1337709493
COMMUNITY LEADER
It's good that your doctor did the confirmatory test to make sure you didn't have syphilis. There's a long list of things that can cause a false positive on an RPR, like pregnancy, autoimmune disorders (especially lupus, but some others), IV drug use, malaria, tuberculosis (TB), lyme disease, certain types of pneumonia.

Some people never figure out why they did, and a 1:1 could really just be a fluke. I couldn't find anything about herpes causing a false positive RPR, even during an outbreak, but that doesn't mean it didn't cause it.

How long ago was your most recent possible exposure to syphilis? It can take some time to test positive. If you've had oral, vaginal or anal sex in the last 6 weeks, it might be too soon. A syphilis sore usually appears at about 3 weeks, though it can anywhere from 10-90 days.
12 Comments
Thanks so much, it was 4 weeks ago protected vaginal intercourse.  I am a male so rules pregnancy out.  Also unprotected oral sex.  I tested for hiv just to be certain my doctor gave me a 4th gen test but that was two weeks from protected intercourse and I also did an rna hiv test 16 days past just to be certain both negative.   Also I have no sores to speak of other then the hsv breakout.  My doctor told me to stop treatment for syphillis (doxycycline) she is confident it’s a false positive.  I retested anyway to be certain
And I am waiting on the results so hopefully this is just a false positive.  Thanks for your response
I would be very surprised if this wasn't a false positive. I mean, it's possible, but I'd be surprised. Syphilis is uncommon in most developed countries, and  you had protected vaginal sex.

I understand why your doctor did the HIV test, but that's a bit of an overreaction, in my opinion.

How's your outbreak? I'm sure this stress isn't helping that. :(

Let me know your results when they come in, and hang in there!
Stress level 10, on Xanax.  Outbreak cleared up within 7 days so all good there.  I overreacted on hiv testing but I am pretty sure I can rule that out based on rna test at 16 days.  And really never had an exposure to speak of for that.  I just read hiv can cause false positives so made me more anxious.  I think my immune system is just run down.  I should get results tomorrow morning
As always thanks for your advice this forum is so helpful
By the way also unprotected oral sex so that is a risk...not sure how often that women have sores in their mouth but I believe that is possible?
You had protected sex - no risk for HIV. Basically, anything that affects the immune system can throw off the RPR - that's why autoimmune disorders are on there.

I don't know your situation, but based on your stress level, I'd guess you are worried about infecting a regular partner. I apologize if I'm incorrect, but if I'm right, you can really relax. Your doctor is convinced it's a false positive, and I am, as well.

Let me know what the results say. Even if it's still a 1:1, that's okay. If you had a new infection, the numbers should be rising much higher. Have you ever had syphilis before?

Relax tonight. :)
No I have not.  And yes worried about my partner.  Thank you I will try
Auntiejessi results came back non reactive. I appreciate your input yesterday you helped
Me get thru a rough night of waiting
I feel relieved but not sure if I should test again at 6 weeks to be certain?  I don’t have any chancres or sores but surely feel run down nauseous etc but that could be due to anxiety
No fever either...the follow up test was 4 weeks post exposure stdcheck says results are 97-99% accurate at that time
No, I don't think you need to. I agree with stdcheck that it's very accurate at that point, and syphilis just isn't that common. You had protected sex, which makes it that much more unlikely that you'd get syphilis.

I think you can move on, knowing you didn't get an STD from this.
Jessie I have some follow up questions I am trying to make sense of all this.  Even though the lesion was swabbed and it showed hsv2 could it be a new hsv1 infection from unprotected oral sex?  The lesion report showed negative for hsv1, reason I am asking is my breakout was in a different location not usually where I get breakouts.
Also, should I be worried about any hepatitis infection from oral sex?  Thanks
No, it would be really unusual to get hsv1 after hsv2, and it would have shown on the culture. (You can get hsv2 easily after getting hsv1, but the reverse is unusual.)

You can get outbreaks anywhere in the area that boxer shorts cover. A lot of people get outbreaks in the same area again and again, but getting one in a different spot occasionally isn't unusual.

No, you don't need to worry about any heps from oral. In theory, that's a risk for hep B, but I've never heard of a confirmed case of transmission from oral sex, either giving or receiving, no matter the gender.

Hep A can be transmitted by rimming, but it's not common. Hep C is only transmitted by blood, so oral isn't a concern. It's rarely transmitted sexually, and when it is, it's usually anal sex.
Thank you again for your help
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