{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,7,2]],"date-time":"2026-07-02T07:59:58Z","timestamp":1782979198566,"version":"3.54.5"},"reference-count":20,"publisher":"BMJ","issue":"9","license":[{"start":{"date-parts":[[2020,9,18]],"date-time":"2020-09-18T00:00:00Z","timestamp":1600387200000},"content-version":"unspecified","delay-in-days":17,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc\/4.0\/"}],"content-domain":{"domain":["bmj.com"],"crossmark-restriction":true},"short-container-title":["BMJ Open"],"accepted":{"date-parts":[[2020,8,6]]},"published-print":{"date-parts":[[2020,9]]},"abstract":"<jats:sec>\n                    <jats:title>Objectives<\/jats:title>\n                    <jats:p>The diagnosis of repeat syphilis and its follow-up remains challenging. We aimed to investigate if IgM testing may assist in the diagnosis of syphilis reinfection\/relapse and its treatment follow-up.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>\n                      This substudy was conducted in the context of a syphilis biomarker discovery study (ClinicalTrials.gov Nr:\n                      <jats:ext-link xmlns:xlink=\"http:\/\/www.w3.org\/1999\/xlink\" ext-link-type=\"clintrialgov\" xlink:href=\"NCT02059525\">NCT02059525<\/jats:ext-link>\n                      ). Sera were collected from 120 individuals with a new diagnosis of syphilis (72 with repeat infections) and 30 syphilis negative controls during a cohort study investigating syphilis biomarkers conducted at a sexually transmitted infection\/HIV clinic in Antwerp, Belgium. Syphilis was diagnosed based on a simultaneous positive treponemal and non-treponemal assay result and\/or positive serum PCR targeting\n                      <jats:italic>polA<\/jats:italic>\n                      . Specimens collected at visit of diagnosis, and 3 and 6 months post-treatment were tested by two enzyme immunoassays (EIAs), recomWell (Mikrogen; MI) and Euroimmun (EU), to detect anti-treponemal IgM. Baseline specimens were also tested for anti-treponemal IgM using a line immunoassay (LIA) recomLine (MI). Quantitative kinetic decay curves were constructed from the longitudinal quantitative EIA results.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>An overall sensitivity for the diagnosis of syphilis of 59.8% (95% CI: 50.3%\u201368.7%), 75.0% (95% CI: 66.1%\u201382.3%) and 63.3% (95% CI: 54.8%\u201372.6%) was obtained for the EU, MI EIAs and MI LIA, respectively. When only considering repeat syphilis, the diagnostic sensitivity decreased to 45.7% (95% CI: 33.9%\u201358.0%), 63.9% (95% CI: 51.7%\u201374.6%) and 47.2% (95% CI: 35.5%\u201359.3%), respectively. IgM seroreverted in most cases 6 months after treatment. Post-treatment IgM concentrations decreased almost 30% faster for initial syphilis compared with repeat infection. The IgM EIAs and IgM LIA agreed from fairly to moderately (Cohen\u2019s kappa (\u03ba): 0.36 (EU EIA); \u03ba: 0.53 (MI EIA); \u03ba: 0.40 (MI LIA)) with the diagnosis of syphilis.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>IgM detection was not a sensitive method to diagnose syphilis and was even poorer in the diagnosis of syphilis repeat infections.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1136\/bmjopen-2019-035838","type":"journal-article","created":{"date-parts":[[2020,9,21]],"date-time":"2020-09-21T17:35:28Z","timestamp":1600709728000},"page":"e035838","update-policy":"https:\/\/doi.org\/10.1136\/crossmarkpolicy","source":"Crossref","is-referenced-by-count":15,"title":["Role of IgM testing in the diagnosis and post-treatment follow-up of syphilis: a prospective cohort study"],"prefix":"10.1136","volume":"10","clinical-trial-number":[{"clinical-trial-number":"nct02059525","registry":"10.18810\/clinical-trials-gov"}],"author":[{"given":"Kara K","family":"Osbak","sequence":"first","affiliation":[{"name":"Department of Clinical Sciences, Institute of Tropical Medicine, Antwerp, Belgium"},{"name":"Department of Medical Microbiology and Infectious Diseases, Erasmus University Medical Center, Rotterdam, The Netherlands"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Achilleas","family":"Tsoumanis","sequence":"additional","affiliation":[{"name":"Department of Clinical Sciences, Institute of Tropical Medicine, Antwerp, Belgium"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-1804-252X","authenticated-orcid":false,"given":"Irith","family":"De Baetselier","sequence":"additional","affiliation":[{"name":"Department of Clinical Sciences, Institute of Tropical Medicine, Antwerp, Belgium"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Marjan","family":"Van Esbroek","sequence":"additional","affiliation":[{"name":"Department of Clinical Sciences, Institute of Tropical Medicine, Antwerp, Belgium"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Hilde","family":"Smet","sequence":"additional","affiliation":[{"name":"Department of Clinical Sciences, Institute of Tropical Medicine, Antwerp, Belgium"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Chris R","family":"Kenyon","sequence":"additional","affiliation":[{"name":"Department of Clinical Sciences, Institute of Tropical Medicine, Antwerp, Belgium"},{"name":"Department of Medicine, Groote Schuur Hospital, Observatory, South Africa"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-2235-6038","authenticated-orcid":false,"given":"Tania","family":"Crucitti","sequence":"additional","affiliation":[{"name":"Department of Clinical Sciences, Institute of Tropical Medicine, Antwerp, Belgium"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"239","published-online":{"date-parts":[[2020,9,21]]},"reference":[{"key":"2026062608024321000_10.9.e035838.1","doi-asserted-by":"publisher","DOI":"10.1371\/journal.pone.0159309"},{"key":"2026062608024321000_10.9.e035838.2","doi-asserted-by":"publisher","DOI":"10.1136\/bmjopen-2013-003347"},{"key":"2026062608024321000_10.9.e035838.3","doi-asserted-by":"publisher","DOI":"10.2807\/1560-7917.ES2014.19.45.20958"},{"key":"2026062608024321000_10.9.e035838.4","doi-asserted-by":"crossref","first-page":"ofy096","DOI":"10.1093\/ofid\/ofy096","article-title":"Repeat syphilis is more likely to be asymptomatic in HIV-infected individuals: a retrospective cohort analysis with important implications for screening","volume":"5","author":"Kenyon","year":"2018","journal-title":"Open Forum Infect 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Geneva World Health Organisation, 2018."}],"container-title":["BMJ Open"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/syndication.highwire.org\/content\/doi\/10.1136\/bmjopen-2019-035838","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,6,26]],"date-time":"2026-06-26T15:14:45Z","timestamp":1782486885000},"score":1,"resource":{"primary":{"URL":"https:\/\/bmjopen.bmj.com\/lookup\/doi\/10.1136\/bmjopen-2019-035838"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2020,9]]},"references-count":20,"journal-issue":{"issue":"9","published-online":{"date-parts":[[2020,9,21]]},"published-print":{"date-parts":[[2020,9]]}},"alternative-id":["10.1136\/bmjopen-2019-035838"],"URL":"https:\/\/doi.org\/10.1136\/bmjopen-2019-035838","relation":{"has-preprint":[{"id-type":"doi","id":"10.1101\/19011148","asserted-by":"object"}]},"ISSN":["2044-6055","2044-6055"],"issn-type":[{"value":"2044-6055","type":"print"},{"value":"2044-6055","type":"electronic"}],"subject":[],"published":{"date-parts":[[2020,9]]}}}