{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,19]],"date-time":"2026-09-19T05:56:09Z","timestamp":1789797369217,"version":"4.0.1"},"reference-count":11,"publisher":"Ovid Technologies (Wolters Kluwer Health)","issue":"2","content-domain":{"domain":["lww.com","ovid.com"],"crossmark-restriction":true},"short-container-title":[],"published-print":{"date-parts":[[2022,7]]},"abstract":"<jats:sec>\n                    <jats:title\/>\n                    <jats:p>Prozone phenomenon is defined as a false-negative response resulting from higher antibody titer which interferes with formation of antigen\u2013antibody lattice, necessary to visualize a positive flocculation test. The prozone effect can be observed in syphilis testing with cases of very high antibody titers, such as secondary syphilis, or with human immunodeficiency virus (HIV) co-infection. We report two cases of prozone phenomenon in secondary syphilis with HIV co-infection who initially tested nonreactive for rapid plasma reagin test but tested positive with further higher dilution.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.4103\/ijstd.ijstd_43_22","type":"journal-article","created":{"date-parts":[[2022,11,16]],"date-time":"2022-11-16T10:14:32Z","timestamp":1668593672000},"page":"183-185","update-policy":"https:\/\/doi.org\/10.1097\/lww.0000000000001000","source":"Crossref","is-referenced-by-count":12,"title":["Prozone phenomenon in secondary syphilis with HIV co-infection"],"prefix":"10.4103","volume":"43","author":[{"given":"Praneet","family":"Awake","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Kalpana","family":"Angadi","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sourav","family":"Sen","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Prasad","family":"Bhadange","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"276","reference":[{"key":"R1-15-20240831","doi-asserted-by":"crossref","first-page":"87","DOI":"10.1001\/jama.1964.03070020015003","article-title":"Syphilis with a negative blood test reaction","volume":"189","author":"Spangler","year":"1964","journal-title":"JAMA"},{"key":"R2-15-20240831","doi-asserted-by":"crossref","first-page":"872","DOI":"10.7326\/0003-4819-113-11-872","article-title":"Effect of human immunodeficiency virus (HIV) infection on the course of syphilis and on the response to treatment","volume":"113","author":"Musher","year":"1990","journal-title":"Ann Intern Med"},{"key":"R3-15-20240831","doi-asserted-by":"crossref","first-page":"384","DOI":"10.1093\/cid\/ciu325","article-title":"Incidence and risk factors for the prozone phenomenon in serologic testing for syphilis in a large cohort","volume":"59","author":"Liu","year":"2014","journal-title":"Clin Infect Dis"},{"key":"R4-15-20240831","doi-asserted-by":"crossref","first-page":"453","DOI":"10.1056\/NEJM198308253090803","article-title":"Abnormalities of B-cell activation and immunoregulation in patients with the acquired immunodeficiency syndrome","volume":"309","author":"Lane","year":"1983","journal-title":"N Engl J Med"},{"key":"R5-15-20240831","doi-asserted-by":"crossref","first-page":"2496","DOI":"10.1001\/archinte.1993.00410210124014","article-title":"Prozone phenomenon in secondary syphilis","volume":"153","author":"Jurado","year":"1993","journal-title":"Has its time arrived? Arch Intern Med"},{"key":"R6-15-20240831","doi-asserted-by":"crossref","first-page":"1569","DOI":"10.1056\/NEJM198706183162503","article-title":"Alteration in the natural history of neurosyphilis by concurrent infection with the human immunodeficiency virus","volume":"316","author":"Johns","year":"1987","journal-title":"N Engl J Med"},{"key":"R7-15-20240831","doi-asserted-by":"crossref","first-page":"1587","DOI":"10.1056\/NEJM198706183162507","article-title":"Neurologic relapse after benzathine penicillin therapy for secondary syphilis in a patient with HIV infection","volume":"316","author":"Berry","year":"1987","journal-title":"N Engl J Med"},{"key":"R8-15-20240831","doi-asserted-by":"crossref","first-page":"47","DOI":"10.4103\/0253-7184.81256","article-title":"Prozone phenomenon in secondary syphilis","volume":"32","author":"Sidana","year":"2011","journal-title":"Indian J Sex Transm Dis AIDS"},{"key":"R9-15-20240831","doi-asserted-by":"crossref","first-page":"1222","DOI":"10.1086\/513427","article-title":"Syphilis and HIV infection: An update","volume":"44","author":"Zetola","year":"2007","journal-title":"Clin Infect Dis"},{"key":"R10-15-20240831","first-page":"856","article-title":"Case series of syphilis and HIV co-infections","volume":"29","author":"Abdul Wahab","year":"2013","journal-title":"Pak J Med Sci"},{"key":"R11-15-20240831","doi-asserted-by":"crossref","first-page":"456","DOI":"10.1016\/S1473-3099(04)01061-8","article-title":"Syphilis and HIV: A dangerous combination","volume":"4","author":"Lynn","year":"2004","journal-title":"Lancet Infect Dis"}],"container-title":["Indian Journal of Sexually Transmitted Diseases and AIDS"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/www.ovid.com\/10.4103\/ijstd.ijstd_43_22","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,8,26]],"date-time":"2026-08-26T15:15:48Z","timestamp":1787757348000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.ovid.com\/10.4103\/ijstd.ijstd_43_22"}},"subtitle":["Two cases"],"short-title":[],"issued":{"date-parts":[[2022,7]]},"references-count":11,"journal-issue":{"issue":"2","published-print":{"date-parts":[[2022]]}},"URL":"https:\/\/doi.org\/10.4103\/ijstd.ijstd_43_22","relation":{},"ISSN":["2589-0557"],"issn-type":[{"value":"2589-0557","type":"print"}],"subject":[],"published":{"date-parts":[[2022,7]]}}}