Terms:
(1) serorevert – The patient has a positive reaction initially but becomes seronegative.
(2) serofast – The person remains seropositive although the titer may be lower.
Factors affecting the rate of seroreversion:
(1) stage of the disease and the duration of infection: A patient with primary syphilis is more likely to serovert than someone with tertiary syphilis (primary > secondary > latent > tertiary).
(2) intensity of the immune stimulus and baseline RPR titer
(3) first episode vs re-exposure (first episode more likely to serorevert)
(4) false positive reactivity
(5) HIV or other disorders affecting immune response
(6) age (young patient more likely to serorevert than older patient)
(7) gender (males more likely to serorevert than females)
A patient with primary syphilis is more likely to serovert than someone with tertiary syphilis (primary > secondary > latent > tertiary).
The person most likely to serorevert: young male, immunocompetent, primary chancre, first exposure.
