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CDC syphilis VDRL nontreponemal test interpretation
VDRL stands for Venereal Disease Research Laboratory test.
- It is a non-treponemal blood test used to screen for and monitor syphilis.
- It detects antibodies to cardiolipin, not antibodies specifically against Treponema pallidum.
- A reactive result is reported with a titre, such as 1:8 or 1:32.
- A reactive VDRL needs confirmation with a treponemal-specific test, such as TPPA/TPHA, FTA-ABS, or treponemal EIA.
- Titres are useful for follow-up: a fourfold fall in titre, for example 1:32 to 1:8, generally indicates an appropriate treatment response.
- False-positive results can occur with pregnancy, autoimmune disease, some infections, older age, and other conditions.
- In suspected neurosyphilis, CSF-VDRL is highly specific when positive, but a negative result does not exclude the condition because sensitivity is limited.
The CDC guidance states that reactive VDRL/RPR results should have a quantitative titre and be confirmed with a treponemal test. Goldman-Cecil Medicine, p. 1346 (Nontreponemal Tests).
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