Confused about syphilis

[Mainman28]

I am a 28 year old straight male who had an unprotected sexual encounter with a woman I didn't know that well around December 13th 2009. I got tested for Chlymedia, Ghonnerea, HIV and Syphilis in early February 2010 like the 1st week of February at a nearby Planned Parenthood. I tested negative for eveything, then around mid April 2010, 2nd week of April, I retested again for all four STD's at my school's, a University, Health Center and again everything came back negative. In June 2010 on the 9th I went back to Planned parenthood and retested for all four STD's once more. I tested negative for HIV, Chlymedia and Ghonnerea, but the doctor said something about me being negative for Syphilis but that something about a very low protein related to Syphilis was detected. I don't understand what that means, something about two parts of the test which totally confused me. She told me to walk away believing that I'm negative but to go back in 30 days for a rescreening to make sure it's not an early infection. So I'm confused do I have syphilis or not? I will most definitly go back for another test. I have not had another sexual encounter since the December 13th 2009 encounter. Wouldn't the syphilis test I took in mid April had been a long enough window period to detect the antibodies for syphilis? It was over 90 days, like 14 weeks. If not should I also be worried about the HIV window period too, The one in mid April was about 3 1/2 months and the one in June was about 5 1/2 months closer to 6 months actually. I don't have any symptoms of syphilis no chancre or rash or anything and I spoke with the woman I had the encounter with and she said she was clean and gets tested every 4 months. I'm just really worried and confused now. Especially about the HIV test. Oh the doctor said something about diseases like Lupus can effect the syphilis test, but to my knowledge I don't have Lupus. Should I be worried about Lupus now too.

[Edward W Hook, MD]

Welcome to the Forum. Like you I find the comment that "very low protein related to Syphilis was detected" confusing but I suspect I can tell you what this means.  You should verify what I am telling you with your doctor.

For purposes of diagnosing syphilis with blood tests two unrelated tests, based on different "antigens" (this are the proteins and other chemicals that are detected by syphilis tests) are used.  For a diagnosis of syphilis to be made, BOTH tests should be positive because either tests alone can sometimes be falsely positive.  My guess is that one of these tests was falsely positive and that is what the doctor was telling you.  False positive tests are relatively common and can be a chance event, can be related to some other process such as a viral infection unrelated to syphilis, or can be related to other unrelated and rare diseases such a lupus.  Trying to figure out "why" a person has a false positive test in an otherwise normal person is not advised as it can be a  "wild goose chase"

Based on what you tell me about your test results and the timing of your encounter of concern, I am confident that you did not get ANY STD including syphilis or HIV and that you do not need further testing.

Thus, my advice is to make sure my explanation for your doctor's statement is correct by checking with her/him and to not worry further about the encounter you described.  I hope my comments help you to do that.  EWH

[Mainman28]

So if I was to retest like the doctor wants me too, is there a possibility that I'll have the same results, will that mean I do have syphilis? Or that there is some other underlying problem? Also do you think I should have a Herpesselect test as well just to make sure I didn't catch herpes. I have no blisters or cuts or chancres of any sort, I do have some dryness when I have an erection or masturbate and itchyness and at times it feels a bit raw, feels a little itchy after I swim in a pool too. It dosen't come and go though it's pretty constant, I have had 4 or 5 doctors and a dermatologist look at it they all said they couldn't see anything just a little dryness and slight redness, all said prob eczema or mild fungal infection and a couple told me (one of them being the dermatologist) it was just in my head. They all said to forget about Herpes, and that it wasn't a yeast infection either cause it would be very pronounced if it was. So maybe the test would be a waste of money. Just would like to rule everything out I could live with eczema.

[Edward W Hook, MD]

No, some people can have lifelong false positve tests for syphilis, in others it is transient. A re-test giving the same result, if my interpretation above is correct, would just confirm that you have a false positive test result.  

I see no clinical reason from what you describe above to warrant testing for herpes.  HSV is not related to false positive syphilis blood tests and nothing that you describe is suggestive. If you test for HSV, there is about a 20% (1 in 5) chance that at will be positive for HSV-2 and 60% chance that it will be postive for HV-1 as though are how common these infections are in the general U.S. population.  Of those with infection, 80-90% of infected persons are not aware thatthey are infected without a blood test.

If you wish to get more information about HSV and testing, as this is beyond the topic of yoour original question, I would suggest you go to the excellent web site run by the American Social Helath Association (Disclosure. Dr. Handsfield and I are both members of the American Social Health Association Board of Directors.)  EWH