Syphilis and blood donors: what we know, what we do not know, and what we need to know

The lack of transfusion-transmitted syphilis in the United States in the past 30 years has led us to question the rationale for continued syphilis testing of blood donors. In addition, the significance of a confirmed positive syphilis test result in a blood donor is not clear. The following 2 questions have been raised: (1) Are we detecting any truly infectious donors? and (2) If not, what is the significance of a confirmed positive test for syphilis in contemporary blood donors? This review will summarize what is and what is not known about syphilis testing in blood donors and will discuss the need for further research to answer these questions.