Syphilis Serology Interpretation Guidelines

EIA Screen

(Treponemal)

RPR

(Non-Treponemal)

TPPA

(Treponemal)

Interpretation

Nonreactive

N/A

N/A

Negative for syphilis. No further testing required, unless clinically indicated.

Reactive

Reactive

N/A

Consistent with untreated or recently treated syphilis. See CDC treatment guidelines.

Follow up RPR titers: Order RPRT

Reactive

Nonreactive

Reactive

Consistent with past successfully treated syphilis.

Early or latent syphilis possible in individuals with no history of treated syphilis.

Reactive

Nonreactive

Nonreactive

Consistent with false positive screening test. No further testing required, unless clinically indicated.