Serologic testing after therapy for syphilis: Is there a test for cure?

Article Abstract:

The incidence of syphilis has risen dramatically in the past few years, and the genital ulcers associated with syphilis seem to make it easier for an individual to transmit the virus that causes AIDS. Standard treatment of syphilis has been benzathine penicillin, and assessment of the effectiveness of therapy has generally been based on following the results of blood tests (serologies). As the organism that causes syphilis is difficult to culture or identify under a microscope, measurement of antibodies to the organism in the blood of the infected person can help determine infection; the decrease and ultimate loss of these antibodies has generally been assumed to mean cure. Recent studies have shown that the decline in these antibodies against syphilis can take months longer than earlier assumed, and declining levels of antibodies does not necessarily reflect a decline in the level of infection. Some people who have been treated with penicillin have still had the syphilis bacterium present in their spinal fluid after therapy has been completed. A brief discussion is presented of the different kinds of tests that are commonly carried out for syphilis. Patients who have been treated with the recommended course of penicillin must still be monitored carefully and for an extended period of time to ensure that they have, indeed, been cured of their disease. (Consumer Summary produced by Reliance Medical Information, Inc.)

Testing, Development and progression, editorial, Syphilis patients

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Serologic response to treatment of infectious syphilis

Article Abstract:

To learn more about the long-lasting effectiveness of treating syphilis, a group of 882 patients in Alberta, Canada, with documented syphilis were treated with antibiotics (benzathine penicillin in most cases; tetracycline or erythromycin in others), then followed for 36 months with regular blood tests to determine whether seroreversion (disappearance of the antibodies manufactured against the infectious organism of syphilis) had taken place. The diagnostic test used was the rapid plasma reagin test. Seroreversion was found to be most common among those experiencing their first bout of syphilis and among those diagnosed at an earlier disease stage (72 percent for a first episode of primary syphilis). Seroreversion was also more likely to be seen in those whose initial serological results were lowest. No patients with early latent syphilis seroreverted. These results are very different from those reported in other studies, particularly those that use different tests to measure seroreversion. The VDRL (a standard test) will often indicate cure as measured by negative serologies by 12 months after therapy, whereas the RPR shows only 50 percent seroreversion at one year in patients diagnosed with primary syphilis. Criteria for determining when treatment is adequate are presented. (Consumer Summary produced by Reliance Medical Information, Inc.)

Blood chemical analysis, blood

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Minocycline compared with doxycycline in the treatment of nongonococcal urethritis and mucopurulent cervicitis

Article Abstract:

Minocycline may be as effective as doxycycline for the treatment of nongonococcal urethritis and cervicitis. Nongonococcal urethritis and cervicitis are different types of inflammation caused by sexually transmitted diseases other than gonorrhea. Among 253 male and female patients with nongonococcal urethritis or cervicitis, 120 were treated with 100 milligrams (mg) of minocycline per day and 133 were treated with 100 mg of doxycycline two times per day over a seven-day period. Response to treatment was similar among men and women in either treatment group depending on the type of sexually transmitted disease. Patients treated with minocycline experienced fewer side effects than those treated with doxycycline.

Health aspects, Drug therapy, Urethritis, Doxycycline, Cervicitis

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