VDRL-RPR (Rapid Plasma Reagin)
Understanding VDRL-RPR (Rapid Plasma Reagin)
What is VDRL-RPR (Rapid Plasma Reagin)?
The VDRL-RPR (Rapid Plasma Reagin) is a blood test used to detect syphilis, a sexually transmitted disease (STD). It detects the presence of antibodies produced by the body in response to the syphilis infection. This test is used for initial syphilis screening and monitoring the effectiveness of treatment in individuals diagnosed with the disease.
Syphilis is a bacterial infection caused by the Treponema pallidum bacterium. The VDRL-RPR (Rapid Plasma Reagin) test helps screen for syphilis in individuals who present with symptoms suggestive of syphilis, such as small and painless sores near the site of infection, skin rash, fever, swollen lymph glands, hair loss, headaches, muscle aches, tiredness, etc. It may also be used to screen individuals who are at high risk, such as sexually active individuals, pregnant women, and people with other STDs. This test also helps monitor the effectiveness of syphilis treatment by measuring changes in antibody levels over time.
The VDRL-RPR (Rapid Plasma Reagin) test is non-treponemal, meaning it does not directly detect the bacteria but rather detects antibodies called reagin, which are produced by the body in response to the cellular damage caused by the bacteria causing syphilis. A positive test result indicates the presence of reagin antibodies, suggesting a current or past syphilis infection. In contrast, a negative test result indicates no detectable reagin antibodies, suggesting the absence of syphilis.
Apart from syphilis, reagin antibodies can also be found in other infections such as tuberculosis, malaria, viral pneumonia, and other autoimmune diseases. Hence, the VDRL-RPR (Rapid Plasma Reagin) test results should be interpreted in conjunction with other specific tests and clinical findings to diagnose syphilis definitively.
The VDRL-RPR (Rapid Plasma Reagin) doesn’t require you to fast or stop taking medications. If your doctor wants you to make an exception, they will inform you before your test. However, avoid alcohol consumption before the test. Drinking alcohol within 24 hours of the test can give a false-negative result.
Test result ranges may vary across laboratories. Abnormal test results require an expert interpretation; therefore, never try to self-medicate at home based solely on these results, and always consult a doctor for a proper understanding of the test results. The insights from this test help the doctor tailor an appropriate treatment plan.
What is VDRL-RPR (Rapid Plasma Reagin) used for?
The VDRL-RPR (Rapid Plasma Reagin) test is done:
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To screen for syphilis in people having symptoms of sexually transmitted infections.
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To screen people who are at risk of exposure to syphilis, such as having another STD or HIV infection, homosexual men having a sexual partner diagnosed with syphilis, or indulging in high-risk sexual activity.
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To screen pregnant women for syphilis.
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To monitor the ongoing treatment response for syphilis.
What does VDRL-RPR (Rapid Plasma Reagin) measure?
The VDRL-RPR (Rapid Plasma Reagin) test looks for antibodies (specific proteins) that react to syphilis in the blood. This means the test doesn't find the actual bacteria that cause syphilis. Instead, it looks for antibodies against substances given off by cells that have been harmed by the bacteria. Antibodies are a specific type of protein produced by your immune system to fight off any invaders, such as bacteria, viruses, or toxins. Detecting these antibodies can help your doctors know if you have syphilis. Untreated syphilis can spread to your eyes, blood vessels, heart, and brain. But it can be easily cured if treated in the early stages.
Interpreting VDRL-RPR (Rapid Plasma Reagin) results
Interpretations
Negative: A negative ("non-reactive") RPR test result is compatible with a person not having syphilis.
The result of this test can be “positive” or “negative”. However, there are some cases where the results can be false positive or negative.
A negative ("non-reactive") RPR test result suggests that a person is not having syphilis. However, the body does not always produce antibodies specifically in response to the syphilis bacteria, so the test is not always accurate. The false-negatives test result may occur in people with early- and late-stage syphilis. Because of that, other tests are required to confirm the results.
A false positive RPR (which means positive results in the absence of syphilis) can be encountered in infectious mononucleosis, tuberculosis, leprosy, malaria, lupus erythematosus, vaccinia, and viral pneumonia. Pregnancy, autoimmune diseases, and narcotic addictions may give false-positive results. Also, this test may give false-positive results in pinta, yaws, bejel, and other treponemal diseases.
RPR test is also used to monitor treatment response. Treatment response is generally indicated by a 4-fold (2-tube dilution) reduction in rapid plasma reagin (RPR) titer (e.g., from 1:32 to 1:8). For proper interpretation of RPR results, titers should be obtained using the same testing method and, preferably, at the same testing laboratory.
Failure of nontreponemal test titers to decline 4-fold within six months after therapy for primary or secondary syphilis may be indicative of treatment failure. Patients whose titers remain serofast should be reevaluated for HIV infection.