Reliability of the Treponemal Hemagglutination Test for the Serodiagnosis of Syphilis

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Abstract
The reliability of the treponemal hemagglutination (TPHA) test for the serodiagnosis of syphilis was evaluated by testing 306 sera with the TPHA and fluorescent treponemal antibody-absorbed (FTA-Abs) tests. Overall agreement between the two tests was obtained with 90.2% of the sera. Fifteen of the discrepant sera were FTA-Abs-positive and TPHA-negative, and fifteen were FTA-Absnegative and TPHA-positive. Careful evaluation of the patients' history and clinical findings indicated a false-positive rate of 8.8% for the TPHA, and a false-negative rate of at least 6.5% for this test. The number of false-positives and false-negatives makes us question the reliability of the TPHA, and it is recommended that the FTA-Abs be retained as the primary treponemal test.

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