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Jan 19, 2009

Dear Dr,

I am a male with vdrl positive in undiluted serum and tpha as 1:32.I have undergone pencillin course 4 yrs back.I would like to know is 1:32 a high tpha ratio and wwwhat does the vdrl above result tells.

thanks and regards.

Response from Dr. Young

Hello and thanks for your post.

The VDRL test is a screening test for exposure to syphilis. It is usually confirmed by a second test, called FTA (or TPHA, as you've called it).

Usually the VDRL and FTA tests will remain positive for life following infection. Treatment with penicillin (the preferred treatment for syphilis) results in the FTA titer decreasing to levels below 1:32. Titers at this level or above suggest that their could be a problem (but not always)- most importantly, among persons with syphilis and HIV infections, titers of 32 or higher could point to neurosyphilis (brain infection). We usually perform a lumbar puncture (spinal tap, yes, ouch), to confirm or negate this very important diagnosis. If positive, you'd have to undergo intravenous antibiotic treatment.

I hope this helps and wish you well,


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