AUTHOR=Xiao Yao , Li Wei , Li Qiu-Ling , Xu Qiu-Yan , Yang Yang , Yang Tian-Ci , Liu Li-Li , Gu Wei-Ming 

TITLE=Which Is the Optimum Antigen Concentration for the Venereal Disease Research Laboratory Test of Cerebrospinal Fluid for Neurosyphilis Diagnosis: 10 or 17 μL?

JOURNAL=Frontiers in Medicine

VOLUME=Volume 9 - 2022

YEAR=2022

URL=https://www.frontiersin.org/journals/medicine/articles/10.3389/fmed.2022.877186

DOI=10.3389/fmed.2022.877186

ISSN=2296-858X

ABSTRACT=The venereal disease research laboratory (VDRL) antigen is tested only with serum in manufacturing, without procedures for cerebrospinal fluid (CSF) testing. This study compared the CSF-VDRL test with 10 μL of antigen (CSF-VDRL-10) according to the American Public Health Association, to the CSF-VDRL test with 17 μL of antigen (CSF-VDRL-17) according to the VDRL serum procedure. A total of 121 neurosyphilis patients and 86 syphilis/non-neurosyphilis patients were included. The sensitivities of the CSF-VDRL-10 and CSF-VDRL-17 tests were comparable for neurosyphilis diagnosis. The positive rate of the CSF-VDRL-17 test was higher than that of the CSF-VDRL-10 test. There were 78.3% of the quantitative CSF-VDRL-17 results consistent with the CSF-VDRL-10 test, 18.4% with one-titer higher results than those from the CSF-VDRL-10 test, and 3.4% with positive CSF-VDRL-17 but negative CSF-VDRL-10 results. The CSF-VDRL test with 17 μL of antigen was more sensitive and it is worth performing longitudinal studies to understand its practical implications.