National Journal of Laboratory Medicine (Oct 2021)

Biological False Positive Venereal Disease Research Laboratory in Hepatitis B and C Infections in a Tertiary Care Hospital, Delhi, India

  • SHIWANGI SHARMA,
  • MALA CHHABRA,
  • NANDINI DUGGAL

DOI
https://doi.org/10.7860/NJLM/2021/49721:2536
Journal volume & issue
Vol. 10, no. 4
pp. 15 – 17

Abstract

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Introduction: Venereal Disease Research Laboratory (VDRL) test is commonly used for screening of syphilis. In India in some centres, the diagnosis of syphilis is based on VDRL test without confirmation by specific treponemal test resulting in Biological False Positives (BFPs) due to non specific nature of antigen used. Both hepatitis and syphilis are sexually transmitted diseases which are widely prevalent in India. Diagnosing syphilis aptly is important due to its association with various complications and social stigmas. Aim: To demonstrate the false-positivity of VDRL test in patients with Hepatitis B Virus (HBV) and Hepatitis C Virus (HCV) infection. Materials and Methods: This was a cross-sectional observational study in which 420 hepatitis B positive and 208 hepatitis C positive serum samples of patients >18 years of age were tested for syphilis by VDRL and Treponema pallidum Haemagglutination (TPHA). VDRL reactive and TPHA negative samples were considered as BFPs. Sera of 90 healthy individuals, which were negative for both Hepatitis B and C were included as control group. The data entry and analysis was done in the Microsoft Excel spreadsheet. Results: Out of 420 hepatitis B reactive samples, 64 (15.23%) and out of 208 hepatitis C reactive samples, 24 (11.5%) were observed to be BFPs. Of these 64 hepatitis B reactive patients, 46 (71.88%) were females and 18 (28.12%) were males with BFP VDRL test. Similarly, out of the 24 hepatitis C reactive patients, 18 (75%) were females and 6 (25%) were males with BFP VDRL test. BFP was observed to be 1.1% in control group. Conclusion: The study highlights that HBV and HCV infection are associated with increased chances of obtaining a BFP-VDRL test. If VDRL test is reactive, then reflex testing should be done with a specific treponemal test for a confirmatory diagnosis.

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