Automated Reagin Testing (ART)

Norm of Automated Reagin Testing (ART)

Negative.

Titer	Interpretation
Nonreactive	Negative
≤ 1:8	False positive
1:9 to 1:32	Primary-stage syphilis (requiring interpretation)
>1:32	Secondary-stage syphilis

 

Positive of Automated Reagin Testing (ART)
Syphilis. (See Factors That Affect Results for biologic false-positive results .)

 

Description of Automated Reagin Testing (ART)

A nonspecific, nontreponemal test used for syphilis screening and monitoring of response to therapy in the post chancre period of the primary stage and in the secondary stage when treponemal antibodies are more difficult to detect. When Treponema pallidum, the causative agent of syphilis, invades human tissue, reagin is produced and can be isolated from 7 to 21 days after the appearance of the chancre. Results are reported as the highest titer that produces a positive reaction.

 

Professional Considerations of Automated Reagin Testing (ART)

Consent form NOT required.
Preparation

1. Tube: Red topped, red/gray topped, or gold topped.
2. See Client and Family Teaching.

 

Procedure

1. Draw a 5-mL blood sample.

 

Postprocedure Care

1. None.

 

Client and Family Teaching

1. Do not drink alcohol for 24 hours before testing.
2. Weekly testing for 2 months is recommended before syphilis can be ruled out.
3. If testing positive:
   • Notify all sexual contacts from the last 90 days (if early stage) to be tested for syphilis.
   • Syphilis can be cured with antibiotics. These may worsen the symptoms for the first 24 hours.
   • Do not have sex for 2 months and until after repeat testing has confirmed that the syphilis is cured. Use condoms after that for 2 years. Return for repeat testing every 3–4 months for the next 2 years to make sure the disease is cured.
   • Do not become pregnant for 2 years because syphilis can be transmitted to the fetus.
   • If left untreated, syphilis can damage many body organs, including the brain, over several years.

 

Factors That Affect Results

1. Reject hemolyzed specimens.
2. False-negative results may occur before the appearance of the chancre in the initial stage of syphilis or during the tertiary stage.
3. False-negative results may be caused by ingestion of alcohol within 24 hours before specimen collection.
4. Biologic false-positive results lasting up to 6 months may be caused by bejel, chickenpox, DPT immunization, hepatitis (infectious), malaria, measles, mononucleosis (infectious), pneumonia (atypical, pneumococcal), scarlet fever, smallpox vaccination, subacute bacterial endocarditis, or tuberculosis.
5. Biologic false-positive results lasting more than 6 months may be caused by hyperglobulinemia, leprosy, leptospirosis, periarteritis nodosa, pinta, rheumatic fever, rheumatoid arthritis, systemic lupus erythematosus, thyroiditis, Vaccinia, or yaws.

 

Other Data

1. Suspected false-positive results should be followed by repeat testing at 3, 6, and 9 months.