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VDRL; RPR (Rapid Plasma Reagin)

Also known as Syphilis Screening Test, Syphilis Detection Test, Syphilis Serology
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Understanding VDRL; RPR (Rapid Plasma Reagin)

What is VDRL; RPR (Rapid Plasma Reagin)?

A VDRL; RPR (Rapid Plasma Reagin) is a blood test that looks for antibodies (specific proteins) against a bacterial infection called syphilis, a sexually transmitted disease (STD). This test helps screen for active syphilis infection and also helps monitor response to ongoing treatment.

Syphilis infection is caused by the bacteria called Treponema pallidum. The infection spreads through contact with a syphilic sore, also called a chancre, usually during sexual activities. It can also be transmitted from the mother to the baby during pregnancy or childbirth. If not treated appropriately, syphilis can stay in the body for years and cause significant harm to the internal organs.

The first and most common sign of syphilis is a painless sore that develops where the bacteria entered the body. The sore typically appears within three weeks of exposure. It usually occurs in the reproductive and oral (mouth) area, and may go unnoticed if it is hidden inside the body. Syphilis can progress through four different stages and causes different symptoms in each stage. The infection is highly contagious in the first and second stages and can easily be transmitted to your sexual partners.

A VDRL; RPR (Rapid Plasma Reagin) for syphilis is performed when you have symptoms suggestive of this infection. These symptoms include small and painless sores near the site of infection, skin rash, fever, swollen lymph glands, hair loss, headaches, muscle ache, tiredness, etc. A VDRL; RPR test is also recommended to screen for the disease in certain groups of people at an increased risk of infection or of transmitting the infection to others.

Non-reactive RPR tests without clinical evidence of syphilis may suggest no current infection or an effectively treated infection. A false positive RPR (means positive results in the absence of syphilis) can be encountered in tuberculosis, malaria, and viral pneumonia. A reactive RPR test suggests past or present infections with the bacteria that cause syphilis. The VDRL; RPR (Rapid Plasma Reagin) test helps determine if the treatment against syphilis is working.

After a course of effective antibiotic therapy, usually the number of antibodies are expected to decrease, and VDRL; RPR (Rapid Plasma Reagin) may help confirm this. So if you are a sexually active adult with HIV or AIDS, you may need to get tested at least once a year. Doctors often use a VDRL; RPR (Rapid Plasma Reagin) to screen pregnant women for syphilis. A syphilis screening test is usually demanded by different states for anyone applying for a marriage certificate.

A VDRL; RPR (Rapid Plasma Reagin) doesn’t require you to fast or stop taking any medications. If your doctor wants you to make an exception, they will let you know before your test. However, avoid alcohol consumption prior to the test. Drinking alcohol within 24 hours of the test can give a false-negative result. 

Test results may vary depending on your age, gender, health history, and other things. Talk to your doctor about your specific test results. Narrate your complete medical history to help the doctor correlate your clinical and laboratory findings. The results will help them evaluate your medical condition; make recommendations for diet, exercise, or medication; and formulate an overall treatment plan.

What is VDRL; RPR (Rapid Plasma Reagin) used for?

A VDRL; RPR (Rapid Plasma Reagin) test is done: 

  • To screen for syphilis in people having symptoms of sexually transmitted infections.

  • To screen people who are at risk of exposure to syphilis such as having another STD or HIV infection, homosexual men having a sexual partner diagnosed with syphilis, or indulged in high-risk sexual activity.

  • To screen pregnant women for syphilis.

  • To monitor the ongoing treatment response for syphilis. 

What does VDRL; RPR (Rapid Plasma Reagin) measure?

A VDRL; RPR (Rapid Plasma Reagin) test looks for antibodies (specific proteins) that react to syphilis in the blood. This means the test doesn't find the actual bacteria that cause syphilis. Instead, it looks for antibodies against substances given off by cells that have been harmed by the bacteria.  Antibodies are a specific type of protein produced by your immune system to fight off any invader such as bacteria, virus or toxins. Detecting these antibodies can help your doctors know if you have syphilis. Untreated syphilis can spread to your eyes, blood vessels, heart and brain. But it can be easily cured if treated in the early stages.

Interpreting VDRL; RPR (Rapid Plasma Reagin) results


Negative: A negative ("non-reactive") RPR test result is compatible with a person not having syphilis.


The result of this test can be “positive” or “negative”. But there are some cases where the results can be false positive or false negative. 

A negative ("non-reactive") RPR test result suggests that a person is not having syphilis. However, the body does not always produce antibodies specifically in response to the syphilis bacteria, so the test is not always accurate. False-negatives test result may occur in people with early- and late-stage syphilis. Because of that other tests are required to confirm the results.

A false positive RPR (means positive results in the absence of syphilis) can be encountered in infectious mononucleosis, tuberculosis, leprosy, malaria, lupus erythematosus, vaccinia, and viral pneumonia. Pregnancy, autoimmune diseases, and narcotic addictions may give false-positive results. Also, this test may give false-positive result in pinta, yaws, bejel, and other treponemal diseases.

RPR test is also used to monitor treatment response. Treatment response is generally indicated by a 4-fold (2-tube dilution) reduction in rapid plasma reagin (RPR) titer (e.g., from 1:32 to 1:8). For proper interpretation of RPR results, titers should be obtained using the same testing method and, preferably, at the same testing laboratory.

Failure of nontreponemal test titers to decline 4-fold within 6 months after therapy for primary or secondary syphilis may be indicative of treatment failure. Patients whose titers remain serofast should be reevaluated for HIV infection.



Answers to Patient Concerns & Frequently Asked Questions (FAQs) about VDRL; RPR (Rapid Plasma Reagin)

Frequently Asked Questions about VDRL; RPR (Rapid Plasma Reagin)

Q. Why is a VDRL; RPR (Rapid Plasma Reagin) test done?

A VDRL; RPR (Rapid Plasma Reagin) test is done to screen syphilis when you experience signs and symptoms like body rashes, mild fever, hair loss, sore throat, weight loss, swollen glands, muscle pains, headaches, etc. This test is also a routine test in prenatal care during pregnancy. It also helps monitor treatment response in known cases of syphilis.

Q. Does this test pose any risks?

A VDRL; RPR (Rapid Plasma Reagin) test is a normal blood test with no risks. However, since this test involves a needle prick to withdraw the blood sample, in very rare cases, a patient may experience increased bleeding, hematoma formation (blood collection under the skin), bruising or infection at the site of needle prick. Most of these symptoms go away in a day or two.

Q. What are the stages of syphilis?

There are four stages of syphilis that include primary, secondary, latent and tertiary syphilis. At the primary stage of syphilis, you might notice single sore or multiple sores in or around the genital areas and lips or mouth in the initial stage. During the secondary stage, you may have rough and reddish brown skin rashes and sores in your mouth, and genital area.The latent stage of syphilis there are no visible signs or symptoms. Without treatment, you can continue to have syphilis in your body for years. In the tertiary stage, syphilis can affect many different organ systems including heart, blood vessels, brain and nervous system. Tertiary syphilis is very serious and would occur 10–30 years after your infection began.

Q. What if my VDRL; RPR (Rapid Plasma Reagin) is positive?

A positive test result means you may have syphilis. Consult your doctor and discuss your test reports. You may be asked to go for a confirmatory test with a more specific test for syphilis, such as FTA-ABS.

Q. What causes false-positive VDRL; RPR (Rapid Plasma Reagin) test results?

False-positive VDRL; RPR (Rapid Plasma Reagin) test results can occur in certain acute and chronic infections, autoimmune diseases such as tuberculosis, malaria, viral pneumonia, lupus, rheumatoid arthritis, HIV, lyme disease, during pregnancy, and after vaccination.

Q. What do you mean by false-negative test RPR results?

False-negative test results mean that the RPR test is negative in the presence of syphilis infection. The body does not always produce antibodies specifically in response to the syphilis bacteria, so the test is not always accurate. False-negatives may occur in people with early and late stage syphilis. Hence, other tests are required to confirm the results.

Q. Is there any cure available for syphilis?

Yes, syphilis is curable with the right antibiotics. However, treatment cannot reverse the damage that might have been caused by the infection. If syphilis is treated too late, it can permanently damage your heart and brain even after the infection is gone.

Q. When is syphilis contagious?

Syphilis is most contagious during the first two stages and the early latent stage. It can spread through sexual routes, therefore, it is known as sexually transmitted disease (STD). It can enter the body through the genitals, mouth, or broken skin. A pregnant woman infected with syphilis can pass it on to her baby.

Q. How can syphilis be prevented?

The best and the most certain method of prevention of syphilis infection is to avoid sexual contact or only to maintain sexual contact with one faithful partner who is not infected.

Q. Can syphilis recur after treatment?

Yes, syphilis infection can recur again if the person again gets exposed to the bacteria causing it.
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VDRL; RPR (Rapid Plasma Reagin) test price for other cities

Price inBangaloreRs. 149
Price inGurgaonRs. 149
Price inMumbaiRs. 149
Price inPuneRs. 149
Price inHyderabadRs. 149
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  1. Syphilis & MSM (Men Who Have Sex With Men) – CDC Fact Sheet [Internet]. CDC; 11 Apr. 2023 [Accessed 28 Sep. 2023]. Available from: https://www.cdc.gov/std/syphilis/stdfact-msm-syphilis.htm#:~:text=Using%20latex%20condoms%20the%20right,not%20covered%20by%20a%20condom. External Link
  2. Rapid Plasma Reagin [Internet]. Rochester, NY: University of Rochester Medical Center; [Accessed 28 Sep. 2023]. Available from: https://www.urmc.rochester.edu/encyclopedia/content.aspx?contenttypeid=167&contentid=rapid_plasma_reagin_syphilis External Link
  3. Syphilis [Internet]. WHO; 31 May 2023 [Accessed 28 Sep. 2023]. Available from: https://www.who.int/news-room/fact-sheets/detail/syphilis External Link
  4. Jindal N, Bansal R. VDRL Test and its Interpretation. Indian J Dermatol. 2012 Sep;57(5):413. doi: 10.4103/0019-5154.100511. PMID: 23112373; PMCID: PMC3482816. [Accessed 28 Sep. 2023]. Available from: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3482816/ External Link
  5. Nyatsanza F, Tipple C. Syphilis: presentations in general medicine. Clin Med (Lond). 2016 Apr;16(2):184-8. doi: 10.7861/clinmedicine.16-2-184. PMID: 27037391; PMCID: PMC4952975. [Accessed 28 Sep. 2023]. Available from: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4952975/ External Link
  6. Peterman TA, Cha S. Context-Appropriate Interventions to Prevent Syphilis: A Narrative Review. Sex Transm Dis. 2018 Sep;45(9S Suppl 1):S65-S71. doi: 10.1097/OLQ.0000000000000804. PMID: 29465640; PMCID: PMC6752042. [Accessed 28 Sep. 2023]. Available from: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6752042/#:~:text=Interventions%20for%20congenital%20syphilis,is%20treated%20early%20in%20pregnancy. External Link
  7. Henao-Martínez AF, Johnson SC. Diagnostic tests for syphilis: New tests and new algorithms. Neurol Clin Pract. 2014 Apr;4(2):114-122. doi: 10.1212/01.CPJ.0000435752.17621.48. PMID: 27606153; PMCID: PMC4999316. [Accessed 28 Sep. 2023]. Available from: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4999316/ External Link
  8. Lum B, Sergent SR. Rapid Plasma Reagin. [Updated 2023 Jul 25]. In: StatPearls [Internet]. Treasure Island (FL): StatPearls Publishing; 2023 Jan-. [Accessed 28 Sep. 2023]. Available from: https://www.ncbi.nlm.nih.gov/books/NBK557732/ External Link


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