A retrospective observational comparative study of VDRL vs. TPHA and their role in serodiagnosis of syphilis in a tertiary care centre


  • Sivakumar S. Department of Dermatology, Venereology and Leprology, Dhanalakshmi Srinivasan Medical College and Hospital, Perambalur, Tamil Nadu, India
  • Banupriya K. Department of Pharmacology, Tirunelveli Medical College, Tirunelveli, Tamil Nadu, India




Syphilis, Serodiagnosis, VDRL, TPHA


Background: Syphilis is difficult to diagnose challenging the clinicians. Combined use of both non treponemal and treponemal serological tests will give correct diagnosis of syphilis.The aim of the study was to evaluate the role of VDRL and TPHA in the serodiagnosis of syphilis.

Methods: Open label retrospective study done in the department of dermatology of a tertiary care centre after getting IEC approval. One hundred and seventy patients’ serological reports done for syphilis during the month January 2017 to May 2017 were taken for the study and were analysed retrospectively after categorizing into three groups. Frequency and percentage of patients who were reactive to VDRL, weakly reactive to VDRL, positive for prozone phenomenon and reactive to TPHA were noted in each group and analysed statistically.

Results: In our study two cases showed biological false positive results in group 1 and three cases in group 3 were biological false reactors. In our study five patients in group 1 and three patients in group 3 were non-reactive to VDRL but were reactive to TPHA due to the presence of Ig G antibodies and all these patients gave a past history of treatment of syphilis.

Conclusions: Our study was successful in evaluating the role of TPHA and VDRL in the sero-diagnosis of syphilis. The VDRL and TPHA being simple and economical tests can be combined in the assessment of syphilis and ensures that no cases are missed.


Kasper D, Fauci A, Hauser S, Longo D, Jameson J, Loscalzo J. Harrison's principles of internal medicine. 19/E. USA; 2015.

Ratnam S. The laboratory diagnosis of syphilis. Canadian J Infect Dis Med Microbiol. 2005;16(1):45-51.

Wicher K, Horowitz HW, Wicher V. Laboratory methods of diagnosis of syphilis for the beginning of the third millennium. Microbes Infection. 1999;1(12):1035-49.

Larsen SA, Pope V, Johnson RE, Kennedy Jr EJ. A manual of tests for syphilis. Washington, DC: American Public Health Association, 1998. Anaesth Intensive Care. 2008;36:260-72.

McHugh DR. Syphilis: an old disease with modern health concerns. In: Nurse practitioner forum 1996;7(1):34-9.

O'Neill PA. A new look at the serology of treponemal disease. British J Venereal Dis. 1976;52(5):296-9.

Garner MF, Backhouse JL, Daskalopoulos G, Walsh JL. The Treponema pallidum haemagglutination (TPHA) test in biological false positive and leprosy sera. J Clin Pathol. 1973;26(4):258-60.

Brown ST, Zaidi A, Larsen SA, Reynolds GH. Serological response to syphilis treatment: a new analysis of old data. J Am Med Assoc. 1985;253(9):1296-9.

Király K, Jobbágy A, Kováts L. Group Antibodies in Fluorescent Treponemal Antibody (FTA) Test** From the Institute for Dermatology and Venereology, Budapest, Hungary. J Investigative Dermatol. 1967;48(1):98-100.

Bindels PJ, Postma MJ, Peerbooms PG, Coutinho RA, Van den Hoek JA. Benefit of the serological screening program for syphilis in pregnant women in Amsterdam in the period 1985-1989. Nederlands tijdschrift voor geneeskunde. 1991;135(29):1319-22.






Original Research Articles