Comparison of a Hemagglutination Treponemal Test for Syphilis (HATTS) with other Serologie Methods for the Diagnosis of Syphilis

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Abstract
Three laboratories participated in studies of a hemagglutination treponemal test for syphilis (HATTS), using as antigen sonicated Treponema pallidum coupled to glutaraldehydestabilized turkey erythrocytes by the bis-diazotized benzidine procedure. A total of 1,056 cases of syphilis (373 untreated and 683 treated) was studied, with 93.7% overall agreement between the HATTS and the fluorescent treponemal antibody-absorbed (FTA-ABS) test. In addition, 1,805 nonsyphilitic sera, including 1,048 from presumably healthy subjects, 502 sera that were biologic false-positives, and 255 sera from patients with diseases other than syphilis, were studied. The HATTS was nonreactive for 99.4% of sera from presumably healthy subjects, 86.9% of biologic false-positive sera, and 84.7% of sera from patients with diseases other than syphilis, compared with FTA-ABS nonreactivity for 99.2% of presumably normal sera, 76.9% of false-positive sera, and 77.3% of sera from patients with other diseases. One laboratory also compared the HATTS with the microhemagglutination-Tre-ponema pallidum (MHA-TP) test. There was no statistically significant (P ≤ 0.01) difference in reactivities among the HATTS, MHA-TP, and FTA-ABS procedures for either 617 syphilitic or 966 nonsyphilitic sera. Studies of reproducibility showed no significant difference in performances of the HATTS by three laboratories, and the HATTS was significantly more reproducible than the MHA-TP test. It is concluded that the HATTS would be a suitable substitute for the MHA-TP or FTA-ABS test as a confirmatory test for the diagnosis of syphilis.

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