Pemeriksaan laboratorium untuk

penyakit menular melalui hubungan

sexual
Dr Fani Ade Irma SpPK
VDRL
The venereal disease research laboratory (VDRL) test
is designed to assess whether or not you have syphilis,
a sexually transmitted infection (STI). 

the bacteria Treponema pallidum

Pemeriksaan antibodi
The VDRL test isn’t always accurate. For example, you
may have false-negative results if you have had syphilis
for less than three months, as your body might take
this long to make antibodies. The test is also unreliable
in late-stage syphilis.
- On the other hand, the following can cause false-
positive results:
HIV
Lyme disease
malaria
pneumonia (certain types only)
systemic lupus erythematosus
tuberculosis
The antibodies produced as a result of a syphilis
infection can stay in your body even after your syphilis
has been treated. This means you might always have
positive results on this test
RPR
A rapid plasma reagin (RPR) test is a blood test used
to screen you for syphilis. It works by detecting the
nonspecific antibodies that your body produces to
fight the infection.
False negatives tend to be more common in the initial
and end stages of infection. Among people who are in
the secondary (middle) stage of infection, the RPR test
result is nearly always positive.
 The RPR test also can produce false-positive results,
suggesting you have syphilis when you actually don’t.
One reason for a false positive is the presence of
another disease that produces antibodies similar to the
ones that fight syphilis. A few of the conditions that
can cause a false positive include the following:
HIV
Lyme disease
malaria
lupus
certain types of pneumonia, especially those
associated with a compromised immune system
If your result is negative, your doctor may ask you to
wait a few weeks and then return for another test if
you are at a higher risk for syphilis. This is because of
the RPR test’s potential for a false negative.
Due to the risk of false-positive results, your doctor
will confirm the presence of syphilis with a second
test, one that is specific for antibodies against the
bacterium that causes syphilis, before starting your
treatment. One such test is called the fluorescent
treponemal antibody-absorption (FTA-ABS) test.
TPHA
treponema pallidum Hemagglutination Assay (TPHA) is a
treponemal test for the serologic diagnosis of syphilis.

Based on the principle of passive

haemagglutination, this test detects anti-
treponemal antibodies (IgG and IgM antibodies) in
serum or CSF.   TPHA  has been used as a confirmatory test
for the diagnosis of Treponema pallidum  infection since
the mid 1960’s.  TPHA is a good primary screening test for
syphilis at all stages beyond the early primary stage
TPHA test is a passive hemagglutination assay based
on hemagglutination of  erythrocytes sensitized
with T. pallidum antigen by antibodies found in the
patient’s serum or plasma.  It is used for both
qualitative and semi-quantative detection of Anti-
treponemal antibodies.
Reactive (R): Reactive results may indicate an active,
past, or successfully treated infection. A diagnosis
should be made with a careful history of the patient
and a physical examination as well as pertinent
laboratory results
False Positive results: Although TPHA test is highly
specific, false positive results have been known to
occur in patients suffering from leprosy, infectious
mononucleosis and connective tissue disorders
HIV
Untuk diindonesia, digunakan strategi III, dimana
pemeriksaan dengan tiga jenis reagensia yg berbeda.
Dapat digunakan reagen cara rapid
(imunokromatografi, dot immunoassay, atau
aglutinasi partikel (latex), atau dengan cara elisa.
Reagen yg dipakai harus terdaftar diDEPKES RI dan
telah diuji sensitifitas dan spesifitasnya.
Pemeriksaan pertama ( screening), harus memakai
reagen yg sensitifitasnya tinggi ≥ 99%
Sedangkan reagen pemeriksaan kedua dan ketiga
harus menggunakan reagensia yg spesifitasnya ≥ 98%
Bila salah satu dari reagen tadi tidak reaktif, maka
harus dilakukan pemeriksaan ulang 2 minggu setelah
pengambilan pertama
Bila hasil tetap non reaktif -------dilaporkan
indeterminate.
Bila terdapat fasilitas western blot, dapat dilakukan uji
konfirmasi dengan Western blot
Pada masa window period dan pada bayi baru lahir,
--------- antigen p24, tes asam nukleat HIV( PCR
provirus dan RT PCR untuk RNA virus)
Pemeriksaan CD4----pengobatan anti viral pada HIV
std 1 dan 2 bila jumlah CD4 < 200µ, pada std 3 CD4 <
350µL dan pada std 4 tanpa melihat jumlah CD4.
Pemeriksaan viral load---monitoring hasil
pengobatan.
TERIMA KASIH