| Clinical Use |
| Treponemal Antibody (CLIA) |
Non-Treponemal (RPR) |
Treponemal Antibody (TPPA) |
Result Long Name |
| Non-Reactive |
Not
Performed |
Not
Performed |
No laboratory evidence of syphilis. If recent exposure is suspected, submit a new sample for testing in 2-4 weeks |
| Reactive |
Non-Reactive |
Non-Reactive |
If the Treponemal Antibody detected has a low antibody index (<4.05) by the CLIA method with the absence of confirmation by the TPPA assay it is due to either a patient with a very early Syphilis infection or a false positive. The
Treponemal Antibody assay using the CLIA method is more sensitive than either the Nontreponemal Antibody (RPR) or the TPPA assay, which is also a Treponemal Ab assay. The clinical history is key in determining whether it is a false positive or a very early stage of infection. If a recent exposure is suspected, submit a new sample for testing in 2-4 weeks; however, if the clinical suspicion is low, it is most likely a false positive, and no further testing is needed. |
| Reactive |
Reactive |
Not
performed |
Treponemal with Nontreponemal antibodies indicate a current or recent past infection. A thorough clinical evaluation is recommended to access for active signs and symptoms or a history of a recent infection.
Approximately 84-90% of infected patients will remain positive for Treponemal antibody for life and the other 10-16% will be positive for many years. Post-treatment monitoring should be performed using only the Nontreponemal antibody (RPR) assay to evaluate treatment response. |
| Reactive |
Non-Reactive |
Reactive |
Only Treponemal antibodies detected, thus most likely consistent with past syphilis infection. Clinical evaluation should be performed to identify current signs and symptoms or past history of infection. If past history of treatment is reported, no further management is needed; however, if recent exposure is suspected, submit a new sample for testing in 2-4 weeks. |
 |