Utility of the VDRL test in HIV-seropositive patients

To the Editor: The Venereal Disease Research Laboratory (VDRL) and other nontreponemal tests for syphilis measure the levels of antibody directed against a cardiolipin—lecithin antigen. False positive reactions can occur in patients with immunoglobulin abnormalities. Patients infected with the human immunodeficiency virus (HIV) often have polyclonal gammopathy, and a majority have anticardiolipin antibodies.¹ False positive nontreponemal tests in patients with HIV make it difficult to evaluate the response to therapy in patients who have syphilis, as exemplified by the following case report. A 61-year-old man with a history of heterosexual promiscuity and syphilis treated in the 1950s presented with hairy.