Of all the diseases that a person acquires sexually, the most common is syphilis. Other infection routes are also known: when using one dishware, a towel, personal hygiene products and other household items together with the patient. In some cases, the disease can be passive, i.e. asymptomatic, but this does not exclude the risk of infection.
The culprit is the pale treponema, which, having penetrated the body, begins to affect all organs. However, being outside the body, it quickly dies. The harmful effect on it is provided by sunlight and detergents with disinfecting properties. When frozen and in a humid environment, the bacterium retains its viability.
Different stages of syphilis. Symptoms Treatment
The insidiousness of this pathology lies in the fact that it occurs with minor symptoms or without them. The following periods are distinguished:
- Incubation - from two weeks to two months. There are no signs of the disease.
- Primary - six to seven weeks. One of the first signs of the disease is the appearance of an ulcer, it forms in the place where the bacteria penetrated. Most often this is the perineum or dermis of the genital organs. After a short period of time, the ulcer disappears without a trace. In some cases, the pathogen enters the bloodstream. This occurs with transfusions, injections, cuts, etc.
- Secondary - two to four years. Recognized as the brightest period. After a month and a half, small spots of pink color, localization on the face and neck are visible on the skin of the individual. If untreated, the disease proceeds to the next stage.
- The third period can last for many years. With it, all organs are affected, dense nodes are formed, the so-called gum, after their destruction, scars remain.
If the antibodies for syphilis are positive, then you should visit a doctor who will prescribe the necessary course of specific therapy. The literature describes cases of atypical development of the disease, which is characterized by the absence of the first and second stages, that is, after a latent period, the disease immediately goes to the last stage. One of the most serious complications of the disease is neurosyphilis, in which joints are inflamed and all internal organs are affected. Thanks to modern and highly effective drugs, such consequences are currently extremely rare.
To treat the disease, antibacterial drugs are used that take a long period. Numerous observations have shown that the disease is treatable with therapy at an early stage of the disease and with the passage of the full course prescribed by the doctor. If antibodies to syphilis are detected in a child, then the treatment will depend on the stage of the disease:
- early congenital - recommend the passage of six courses of specific treatment with a break of two weeks;
- late congenital - eight courses.
Children who have been treated should be under the supervision of a doctor for five years, and then they are deregistered.
Syphilis Classification
The following types of syphilis are divided:
- Early - lasts an average of about two years. There are several periods of the disease: incubation, primary, secondary. Timely started therapy brings a tangible effect. Complications are reversible.
- Late - has one tertiary period. The remaining pathogens provoke allergic manifestations that are destructive to the body. Under the influence of the disease, the immune system begins to rebuild. Trying to protect themselves from bacteria, the protective cells form seals around them, the so-called infiltrates, consisting of lymph, blood and cellular tissue of the immune system. Further, purulent processes develop inside these seals, leading to ulcerative lesions that damage closely located tissues.
- Hidden - it is identified according to the results of the study. Antibodies to syphilis are found in the blood. This type of disease is divided into the earliest - less than two years have passed since the penetration of the pathogen into the body, and the late - more than two years.
Syphilis forms:
- Hidden - found in the primary and secondary period.
- Manifested - in the secondary and tertiary.
In what cases is a study prescribed for antibodies to treponem?
The doctor prescribes this type of study with:
- visiting a doctor for the first time;
- pregnancy
- taking drugs;
- admission to a health care facility for inpatient treatment;
- suspected syphilis in contact with the patient;
- abortion;
- donation of biological fluids for donation;
- joining the institutions of the social sphere, trade, medical organizations.
What biomaterial is suitable for diagnosing a disease
Basically, blood is used for diagnosis, from which antibodies to syphilis are isolated, as well as treponema DNA. Directly the pathogen itself is easiest to detect by taking a scraping from the rashes that appear with syphilis. DNA is also detected by examination from another biomaterial, for example, urine, dermal cells and others, i.e., from organs affected by the disease. Blood is taken from a vein or from a finger, depending on the type of study. It is advisable to collect biomaterial for the detection of pathogen DNA before using antibiotics. Scraping from the mucous membranes or the surface of the dermis does not require special preparation. Women before submitting biomaterial from the vagina in order to detect antibodies to syphilis should refrain for two days from:
- sexual contact;
- gynecological procedures performed for the purpose of diagnosis;
- douching.
In addition, the market offers a fairly wide selection of rapid tests for which blood is taken from the finger. To refute or confirm the results of the study at home can be the method of serodiagnostics, which is carried out in a laboratory.
Contraindications to undergoing treponem antibodies
It is not recommended to take biomaterial in the following conditions, as otherwise antibodies to the syphilis pathogen will be detected and the result will be false:
- in the first ten days after delivery;
- in the period of an infectious disease or in the first days after recovery;
- with hypothermia;
- before childbirth;
- during menstruation;
- and some others that the attending doctor will talk about.
Total antibodies to syphilis
In the third or fourth week after infection, antibodies are formed in the individual’s blood, i.e. the immune system thus tries to cope with the pathogen. All synthesized compounds are divided into early immunoglobulins M (antitreponemal bodies) and late immunoglobulins G (antilipid bodies). The first (antitreponemal bodies) appear seven to fourteen days after the penetration of treponema into the body. With timely treatment, the level of bacteria decreases rapidly. The second (antilipid bodies) are formed later and are a response to the processes occurring in the body.
Their number increases after the fourth week of infection. Both types of antibodies to syphilis are present in the body after a full course of therapy. However, it should be remembered that their presence is not a guarantee of protection against reinfection. In a baby, the presence of M immunoglobulins in the blood, which are formed from the third week of pregnancy, is taken into account. They are transferred to the fetus from the mother. Antibodies disappear in about a year and a half after the baby is born. Their presence in the baby indicates congenital syphilis.
In order to exclude diagnostic errors, doctors recommend the study of total antibodies to syphilis by the ELISA method. Using an analysis for syphilis of RPHA (analysis for the reaction of passive hemagglutination) in combination with other tests, you can confirm any stage of the disease.
Serological tests at different periods of the disease
Tests are divided into:
- Treponemal (ELISA, RPGA, RIF, immunoblotting) is an accurate and expensive method. The study uses specific antigens that respond directly to the pathogen, that is, pale treponema.
- Nontreponemal (RW, RPR, RMP) - a microorganism analogue, the cariidolipin antigen, is used for research. These tests are cheaper, with their help they quantify antibodies to syphilis, and not just their presence. They respond to non-specific antibodies - IgM and IgG. These tests are indicated if it is not known whether an individual is sick or not. However, the results can be false positive, a treponemal test is prescribed to confirm.
Research results depend on the period of the disease:
- Primary - after a different number of days, both types of tests become positive. If a disease is suspected, a diagnosis is made using PCR, or serological tests are repeated again after two weeks.
- Secondary - all tests are positive, in this period the number of antibodies is the largest.
- Tertiary - treponemal tests are positive, and nontreponemal tests are negative due to the fact that IgM antibodies from the blood disappear.
- After successful treatment of syphilis, antibodies according to the results of non-treponemal tests are reduced. One and a half years after the start of therapy, these tests should be negative. Treponemal - remain positive.
Wasserman Reaction (RW)
It has been used to diagnose the disease since 1906. The bottom line is that the blood serum taken from the patient, entering into a chemical reaction, forms a complex with the corresponding antigens. Therefore, it was called the “complement binding reaction” and is designated as CSC. The methods used to diagnose syphilis at present are different from the original, or it is also called classical, but the phrase "Wasserman reaction" is preserved. After infection, the immune system begins the synthesis of antibodies and throws them into the blood of a sick individual.
In the causative agent of the disease is an antigen called "cardiolipin", it is he who provokes the production of antibodies that can be detected by conducting the Wasserman reaction. A positive result confirms the disease, as it indicates the presence of such antibodies in the blood. Currently, laboratories are increasingly using a more accurate method of microprecipitation, which has the letter designation RMP, gradually displacing the Wasserman reaction.
Antibodies to the causative agent of syphilis: immunoglobulins (IgM, IgG, IgA)
Antibodies, or immunoglobulins, are synthesized in the body to combat the pathogen. Each of the proteins is different in structure, carries certain information and has its own purpose:
- Imunoglobulins A - belong to early antibodies, they are responsible for local immunity. Quite a lot of them are synthesized in the mucous membrane of the mouth, intestines, respiratory organs, and a small amount in the blood. These antibodies appear in the first weeks of infection, their detection indicates the presence of inflammation, they are nonspecific and able to respond to various bacteria that enter the body, therefore, they are practically not used for the diagnosis of syphilis.
- Immunoglobulins M - also belong to early antibodies to syphilis, but are responsible for general immunity in the body, i.e. for the entire defense system. They are characterized as weakly specific. They are synthesized two weeks after the introduction of the pathogen. You can identify them after five to six weeks. Their development is carried out in the primary and secondary period, and in the tertiary - they disappear. IgM detection is a sign of the active stage of the disease.
- Immunoglobulins G are late protein-specific compounds that appear four to five weeks after infection. The body remembers them and continues to produce them for a long time after pharmacotherapy. However, they do not protect the individual from reinfection.
If you do a study on each class of antibodies to syphilis by the ELISA test, then the results are interpreted as follows:
- the pathogen is present in the body for less than two weeks, detect IgA;
- infection occurred less than four weeks ago - IgA and IgM;
- infection occurred more than four weeks ago - all types of proteins are detected: IgA, IgM and IgG;
- late syphilis or effectively treated - IgG.
How long do antibodies circulate in the blood?
A feature of antibodies (protective proteins) is that even after proper treatment with antibacterial agents, they do not completely disappear, although their number is significantly reduced. This phenomenon worries individuals, as they want to quickly forget and not remember this unpleasant pathology. Doctors warn in advance that for a long period in the patient’s blood the total antibodies to syphilis remain. After treatment of the early stage, they go away after about two years, and such types of studies as RPR, RW, RMP will give a negative result. After late syphilis, they remain for life, and in some individuals they can disappear after a few years. This is explained by the following reasons:
- For a long period in the body there are particles of dead pathogens (treponem). As long as they remain, the synthesis of protective cells will continue.
- Not the last role is played by the individual characteristics of the immune system. In some individuals, their synthesis stops earlier, while in others - later.
It should be remembered that it is impossible to completely get rid of antibodies after syphilis, and this should not be done, since these cells are not dangerous.
Syphilis causes serious complications, but they develop quite slowly. Therefore, the individual has time to undergo an examination and when confirming the diagnosis of treatment, that is, until the consequences become irreversible.