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Depressed CD4/CD8 ratio in TPHA-negative patients with syphilis
T Kanda1, H Shinohara, T Suzuki
1Gunma University School of Medicine, Japan.
Microbiology and Immunology
|January 1, 1992
Summary
The Treponema pallidum hemagglutination assay (TPHA) may miss syphilis in elderly individuals. Immunological impairment in older adults can lead to false-negative TPHA results, necessitating further testing.
Area of Science:
- Immunology
- Infectious Diseases
- Geriatrics
Background:
- The Treponema pallidum hemagglutination assay (TPHA) is a standard syphilis screening test.
- Elderly patients may present with atypical disease manifestations and altered immune responses.
Purpose of the Study:
- To investigate the diagnostic utility of TPHA in elderly patients with syphilis.
- To compare immunological profiles of TPHA-negative versus TPHA-positive syphilis patients.
Main Methods:
- Retrospective analysis of six elderly syphilis patients with negative TPHA, positive RPR, and positive FTA-ABS.
- Immunological analysis comparing CD4 and CD8 cell counts and ratios in TPHA-negative and TPHA-positive syphilis groups.
Main Results:
- Elderly patients with syphilis can have false-negative TPHA results.
- TPHA-negative syphilitic patients exhibited significantly lower CD4 cell counts and percentages compared to TPHA-positive patients.
- A lower CD4 to CD8 ratio was observed in TPHA-negative syphilitic individuals.
Conclusions:
- The TPHA test may be insufficient for reliably diagnosing syphilis in the elderly due to age-related immunological changes.
- Immunological impairment in aged individuals can affect TPHA test accuracy.
- Consideration of alternative or confirmatory testing is crucial for syphilis diagnosis in elderly patients.