From the Research
Ethanol (ETOH) use does not cause false positive syphilis test results. The standard screening tests for syphilis, such as the RPR (Rapid Plasma Reagin) and VDRL (Venereal Disease Research Laboratory), detect antibodies against cardiolipin-cholesterol-lecithin antigens, not ethanol metabolites. False positives in syphilis testing are typically associated with other conditions like:
- Autoimmune diseases (lupus)
- Certain infections (HIV, hepatitis, pneumonia)
- Pregnancy
- Advanced age
- Recent vaccination While chronic alcoholism can cause liver damage that might indirectly affect some blood tests, there is no established direct mechanism by which alcohol consumption interferes with syphilis serology 1. If a patient with alcohol use disorder receives a positive syphilis screening test, it should be taken seriously and confirmed with more specific treponemal tests like FTA-ABS or TP-PA, as the result is unlikely to be a false positive caused by alcohol consumption alone. The most recent and highest quality study, published in 2024, evaluated the performance of commercially available tests for the diagnosis of syphilis infection and found that the sensitivity and specificity of these tests are high, with no mention of ethanol use as a cause of false positive results 1. Therefore, alcohol consumption is not a concern for false positive syphilis test results, and a positive test should be investigated further to confirm the diagnosis.