Erbelding E J, Vlahov D, Nelson K E, Rompalo A M, Cohn S, Sanchez P, Quinn T C, Brathwaite W, Thomas D L
Department of Medicine, Johns Hopkins University School of Medicine and School of Hygiene and Public Health, Baltimore, Maryland 21205, USA.
J Infect Dis. 1997 Nov;176(5):1397-400. doi: 10.1086/517330.
Injection drug users were assessed serologically for human immunodeficiency virus infection and syphilis every 6 months. Treatment histories were reviewed for any high-titer biologic false-positive (BFP) reactors, that is, persons with rapid plasma reagin (RPR) titers > or = 1:4 and negative results for fluorescent treponemal antibody absorption (FTA-ABS) tests. Selected sera were analyzed further by immunoblotting for the presence of antibodies reactive with specific Treponema pallidum antigens. Of 112 BFP reactors, 35 (31%) had at least one RPR test reactive at a dilution >1:8 while the FTA-ABS test remained nonreactive. Five reactors (4.5%) converted from nonreactive to reactive by FTA-ABS test; 4 (3.6%) were reactive by FTA-ABS tests but later became nonreactive. Antibodies to T. pallidum membrane antigens were detected in some samples that were persistently nonreactive by FTA-ABS test. Serologic patterns over time, along with very high-titer BFP reactions and reactivity with T. pallidum-specific antigens, suggest that some BFP reactions may represent FTA-negative syphilis.
对注射吸毒者每6个月进行一次血清学检测，以评估其是否感染人类免疫缺陷病毒和梅毒。对所有高滴度生物学假阳性（BFP）反应者，即快速血浆反应素（RPR）滴度≥1:4且梅毒螺旋体荧光抗体吸收（FTA-ABS）试验结果为阴性的人，回顾其治疗史。对选定的血清进一步进行免疫印迹分析，以检测是否存在与特定梅毒螺旋体抗原反应的抗体。在112名BFP反应者中，35名（31%）至少有一次RPR试验在稀释度>1:8时呈反应性，而FTA-ABS试验仍为非反应性。5名反应者（4.5%）FTA-ABS试验从非反应性转为反应性；4名（3.6%）FTA-ABS试验呈反应性，但后来变为非反应性。在一些FTA-ABS试验持续呈非反应性的样本中检测到了针对梅毒螺旋体膜抗原的抗体。随着时间推移的血清学模式，以及非常高滴度的BFP反应和与梅毒螺旋体特异性抗原的反应性，表明一些BFP反应可能代表FTA阴性梅毒。
