Last updated: May 18, 2026
Syphilis is one type of sexual transmitted disease which is commonly seeing in my office. The clinical that presents it was varied from a painless genital ulcer compared to a rash at palm and sole, depend on the stage of the infections. The blood test is the only way to confirm diagnosis for the disease, but the problem is, each blood test has pros and cons. Most of patients more likely confusing on it, especially, when their test confirmed positive. And the other thing while they didn’t have a full explanation from physicians it will mislead them to seek out another second opinions or advices. In this topic, we will figure out about the difference type of the tests and how to use them wisely.
Nontreponemal tests – it would be named as a “Screening test” for syphilis suspicious infections. More often, we use this test as a primary investigation. The pros, is the ability of the detective for an active syphilis infection which either used to trace the possibility of the treatment whether it works or not.
Common nontreponemal syphilis tests in Cambodia
- VDRL (Venereal disease research laboratory)
- RPR (Rapid plasma reagin)
Treponemal tests – it would be named as a “Confirmation tests”. If anyone got positive test from VDRL or RPR, it must do the reconfirming diagnosis with treponemal tests. The pro of this test is, it was very accuracy but unfortunately, we don’t know that the syphilis is currently in the active stage or not, that is the weak point of it. Additionally, the treponemal test will always positive in whole your life even a completely cured were done. Therefore, we cannot rely on the tracing’s treatment outcome via the treponemal tests only. This is why the patient must be carefully and pay attention more on the explanation about this information.
Common treponemal syphilis tests in Cambodia
- TP-PA (Treponemal Pallidum particle agglutination)
- FTA-ABS (Fluorescent Treponemal antibody absorbed)
Syphilis is a common disease that very easy to get treated, but the important thing is, how to make your treatment correctly and get educated your patient properly. When the patients educated and fully understanding about their problems and they can actually knowing how to trace the disease that currently they are in, then they will never and ever experience in the panic condition any more. So the point is, you need probably binding a good communication and relations a little stronger than before in order to get a high success treatment and cure on this kind of disease – syphilis. Have a good day.
Any questions, you can feel free to discuss with me.
If you have concerns about syphilis blood test results or need diagnosis and treatment for a sexually transmitted infection, Dr. Soarawee Weerasopone offers confidential specialist consultations at Bangkok Hospital Headquarters. Book a Consultation.
Frequently Asked Questions about Syphilis Blood Tests
Nontreponemal tests (VDRL, RPR) are used as screening tests to detect active syphilis infection and to monitor treatment response. Treponemal tests (TP-PA, FTA-ABS) are confirmation tests that are highly specific for syphilis but remain positive for life even after successful treatment, so they cannot be used alone to assess treatment outcome.
A positive VDRL or RPR is a strong indicator but not a definitive diagnosis. These screening tests can occasionally produce false positives due to other conditions such as autoimmune diseases or viral infections. A confirmatory treponemal test (TP-PA or FTA-ABS) is always required to make a definitive diagnosis of syphilis.
Treponemal tests detect specific antibodies against the syphilis bacterium that persist in the bloodstream for life once produced, even after the infection has been completely cured. This is a normal finding and does not mean the infection is still active. Treatment success is monitored using nontreponemal tests (VDRL or RPR), which should show a declining titer after effective treatment.
Treatment response is tracked by monitoring the VDRL or RPR titer over time. After successful treatment, the nontreponemal titer should decrease fourfold or more within 6–12 months. A stable or rising titer may indicate treatment failure or reinfection, requiring further evaluation by a specialist.
Yes, syphilis is highly curable, especially when diagnosed and treated early. The standard treatment is penicillin G injection, with the dose and duration depending on the stage of infection. Early diagnosis, correct treatment, and regular follow-up blood tests are essential to ensure complete cure and prevent complications or transmission to partners.
Disclaimer: This content is written and reviewed by Dr. Soarawee Weerasopone, a board-certified urologist at Bangkok Hospital Headquarters. It is intended for educational purposes only and does not constitute medical advice. Always consult a qualified healthcare professional before starting any medical treatment.
Medically written & reviewed by: Dr. Soarawee Weerasopone (Dr. Pom) — Board-Certified Urologist, Bangkok Hospital Headquarters. International Fellow: Baylor College of Medicine (USA) · Juntendo University (Japan) · Chang Gung Memorial Hospital (Taiwan).
Dr. Soarawee Weerasopone (Dr. Pom) is a board-certified urologist at Bangkok Hospital Headquarters, specializing in Men’s Health, Robotic Surgery (Da Vinci System), and Kidney Stone treatment. He has completed international fellowships at Baylor College of Medicine (USA), Juntendo University Hospital (Japan), and Chang Gung Memorial Hospital (Taiwan). All medical content on this site is written and reviewed by Dr. Soarawee based on his clinical experience and international training.
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