The FT Antibody in the FTA-ABS test is a fluorescently labeled immunoglobulin that binds specifically to Treponema pallidum antigens. This test is used to:
Confirm reactive results from non-treponemal screening tests (e.g., VDRL or RPR) .
Exclude neurosyphilis when cerebrospinal fluid (CSF) testing is negative .
Resolve discrepancies between clinical findings and other serological results .
The FTA-ABS test remains positive indefinitely post-infection, making it unsuitable for monitoring treatment response .
The FTA-ABS procedure involves:
Antigen Preparation: Lyophilized T. pallidum extracted from rabbit testicular tissue is fixed on a slide .
Absorption Step: Patient serum is pre-treated with Treponema phagedenis extract to remove non-specific antibodies .
Detection:
Neurosyphilis Exclusion: A negative CSF FTA-ABS test rules out neurosyphilis with near 100% sensitivity .
Late-Stage Syphilis: Detects antibodies in latent or tertiary syphilis cases where non-treponemal tests may fail .
Pregnancy and Autoimmune Diseases: Resolves false positives from conditions like lupus or pregnancy .
Parameter | FTA-ABS | VDRL/RPR | TP-PA |
---|---|---|---|
Sensitivity (%) | 92–96 | 54–69 | 81–95 |
Specificity (%) | 98–99 | 85–99 | 99+ |
Sensitivity: 92% in treated latent syphilis; 96% in neurosyphilis .
False Positives: Rare but possible in lupus, leprosy, or other treponemal infections (e.g., yaws) .
Test | Role | Turnaround Time | CSF Utility |
---|---|---|---|
FTA-ABS | Confirmatory, neurosyphilis | 1–4 days | High |
VDRL | Screening, therapy monitoring | Hours | Moderate |
TP-PA | Preferred confirmatory test | 1–3 days | Limited |
Persistence: Remains positive for life, limiting use in treatment monitoring .
CSF Specificity: Less specific in CSF for neurosyphilis diagnosis compared to VDRL .
Cross-Reactivity: May react with non-syphilis treponemes (e.g., T. pertenue) .
While newer assays like chemiluminescence immunoassays (CLIA) are replacing FTA-ABS in some settings, it remains a gold standard for resolving ambiguous cases . Research continues to refine absorption steps to reduce false positives .
Component | Details |
---|---|
Specimen | Serum, CSF, or other fluids |
Methodology | Indirect Fluorescent Antibody (IFA) |
CPT Code | 86780 |
LOINC Code | 17726-1 |
Result | Interpretation |
---|---|
Positive | Current or past syphilis infection |
Negative | No syphilis infection |