Monitoring
Non-treponemal tests are repeated to monitor active infection and treatment response. Titres should generally decline fourfold within 12 months after treatment of primary or secondary syphilis and within 24 months after treatment of latent or late syphilis.[8][37]
Venereal Disease Research Laboratory or rapid plasma reagin titres should be measured monthly after treatment for 3 months, and then every 3 months thereafter. The same non-treponemal test should be used sequentially when monitoring treatment response.[36] This is because results obtained from one test are not directly comparable with that of the other, non-treponemal test.
With effective treatment, non-treponemal tests should become negative. However, some patients who have received adequate treatment become serofast, maintaining a low-level positive titre. This is their baseline titre from which re-infection is assessed.
There are no data to suggest a benefit to performing repeat cerebrospinal fluid examination in immunocompetent patients, or in patients with HIV who are on antiretroviral treatment, if serological and clinical responses are observed after the treatment for neurosyphilis.[8]
Use of this content is subject to our disclaimer