Abstract
Background
We compared the reactive plasma regain (RPR) titre on the day of initial presentation to the day of syphilis treatment to inform clinical practice as to whether a repeat RPR test should be recommended.
Methods
We undertook a retrospective study between 1-March-2011 and 31-December-2020 at the Melbourne Sexual Health Centre in Australia among individuals who received syphilis serology on the day of initial presentation and the day of treatment, if it were within 14 days after initial presentation. We calculated the percentage of individuals with a four-fold or greater RPR change, stratified by the time between initial presentation and treatment, and syphilis stages.
Results
Of the 766 included syphilis cases, the median number of days between initial presentation and treatment was 6 (IQR = 5-7). There were 14.8% (
n = 113) of cases that had a four-fold increase o r decrease between the day of initial presentation and the day of treatment. The number of cases with a 4-fold increase or decrease in RPR titre increased with increasing number of days between the day of initial presentation and day of treatment, i.e., 4.1% (
n = 6) within 1-3 days after initial presentation to 25.7% (
n = 27) with 10-14 days after initial presentation (p
trend < 0.0001). There was no significant difference in the number of cases with 4-fold increase or decrease in RPR between syphilis stages (p = 0.37).
Conclusion
Our data support the recommendation of repeating the RPR titre if the day of initial presentation and treatment are different, even when treatment is within a few days of the initial presentation.
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