[Question #5010] Syphilis Testing

25 months ago
I am a heterosexual male that had unprotected oral sex on December 17 the woman promises that she does not have any STDs but I went and got tested for syphilis and had the hep acute panel done as well on January 18th. All the results came back negative the syphilis test done was the IgM/IgG test. I was wondering how accurate the test were and now that on Feb 25th it will be 70 days post potential exposure if I should get retested. Thank You. 
H. Hunter Handsfield, MD
H. Hunter Handsfield, MD
25 months ago
Welcome to the forum. Thanks for your confidence in our services and for your succinct question.

The chance of syphilis from a single oral sex exposure, i.e. mouth to penis, with a female partner, is extremely low. And if you had caught syphilis, almost certainly you would have developed a chancre, i.e. the initial sore caused by syphilis, on your penis. You would not have missed it. So I would not have considered syphilis testing necessary in this situation. However, your negative result, in combination with the virtually zero chance you were infected, is conclusive. There is no need for an additional test.

For what it's worth, I also would have recommended against an STD test panel including hepatitis. There is no chance of either hepatitis A or B from an oral sex exposure. The highest risk from this sort of exposure is urethral gonorrhea, but presumably your panel included a urine gonorrhea/chalmydia test. If that was negative, you're home free.

So all is well. There is no need for any further testing of any kind, at 70 days or any other time.

I hope these comments are helpful. Let me know if anything isn't clear.

HHH, MD
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25 months ago
I got a urine sample taken 3 days after  potential exposure they said it was incubated and that it was all in the clear.  I had read some of yours and the other doctors responses to similar questions I just needed to get confirmation that I have nothing to worry about. 

Also this is a very informative forum thank you and the other doctors for giving people accurate information. Most of the information on the internet is doom and gloom. 
25 months ago
Just a few final questions as this is my third time posting on this question. 

Dr. Hansfield you said that at 32 days the syhilis test igg/igm  is accurate with the low risk involved correct? Also would a  HIV 4th generation test also be accurate with the same low risk involved? I know the research has moved 4-6 but you’ve said in the pass that it’s 99% conclusive at 4 weeks. 

Also thank you for the informative forum and y’all of your expertise. 
H. Hunter Handsfield, MD
H. Hunter Handsfield, MD
25 months ago
Yes, the HIV AgAb (4th gen) blood tests are 98-99% reliable at 4 weeks (and probably at 32 days), and 100% for testing 6 weeks or more after exposure.

Thanks for the thanks about our services. I'm glad to have helped. Best wishes and stay safe.
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