[Question #13587] Interpreting Conflicting At-Home and Laboratory Syphilis Test Results

 
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1 days ago
I had a single sexual encounter 18 months ago, my only potential exposure to syphilis. At 2.5 months after the exposure, I did 2 or 3 at-home rapid syphilis tests, all showing very faint grey positive lines but blood samples were minimal and a bit dry. Brand unknown but assumed reliable?

I later had laboratory tests: RPR at 3, 9, 10, 12, and 16 months. TPAB x2 at 15 months. TPHA at 16 months. ALL NEGATIVE. Supplements, 150 mcg biotin were paused before TPHA. I have never received syphilis treatment. 

1. How significant is the rapid test brand, and do their faint positives hold diagnostic weight given later lab results?
2. Is my 3-month RPR sufficient to rule out infection, despite the faint positive rapid test?
3. Considering all lab results, is further testing needed to conclusively prove I was never infected in the first place? 

Thanks so much!
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Edward W. Hook M.D.
1 days ago
I happened to be on the forum when your new, repetitive questions arrived.  Follow ups may take longer.  

I’m not sure why you’re back.  Your questions have been answered by our prior responses and repeating them is not going to change the answers.  Further, your testing history is a great example of the hazards of overtesting.   Brief answers:

1.  You are overreading the rapid test results.  STOP the rapid tests!!! Your RPR and TPHA are the results to be believed.
2.  YES,YES, YES!!!
3.  You’ve been told the is no need for further testing.  That answer is not going to change.

A final comment.  Your fixation on syphilis is not serving you well.  The best advice I can provide you is to strongly encourage you to seek counseling about how to address the anxiety and, I would guess, guilt over your dalliance nearly two years ago.  I say this out of concern for you, nothing more.  EWH
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