2023-11-05 18:29:23
The High Council of Public Health (HCSP) is questioned about the existence of biological tests to determine that a person has been cured of syphilis for at least a year, in the hope of being able to reintegrate them into the transfusion chain, as discussed in Directive 2002/98/EC concerning certain technical requirements relating to blood and blood components.
The biological tests used to qualify blood donations are treponemal tests (TT) which detect antibodies directed against the bacteria responsible for syphilis. These antibodies are present well beyond a year, even if the person is cured.
There are also non-treponemal tests (NTT) that detect anti-cardiolipin antibodies during infection. TNTs have the advantage of being positive in the acute phase of the disease and becoming negative again in cases of treated and cured syphilis. However, TNTs can remain negative for up to 6 weeks after the onset of infection and the stage of infection cannot be determined without anamnestic or clinical context.
There are also many cases of reinfection, syphilis not being an immunizing disease, as well as false positive results. The result is that no robust biological indicator makes it possible to distinguish recent syphilis from serological scars in the absence of a clinical context.
Furthermore, the HCSP questioned theEuropean blood alliance to find out the practices in force in other European countries: the 13 countries which responded definitively exclude donors presenting biological signs of confirmed syphilis.
Considering these elements and the primary need to preserve the safety of recipients, the HCSP recommends maintaining the definitive exclusion of candidates for blood donation as long as they are or have been confirmed positive by the presence of anti-syphilis antibodies. .
The HCSP also recalls the importance of filling out the pre-donation questionnaire very accurately, particularly in terms of sexual behavior, because TT can be negative at the very early phase of primary infection.
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