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.
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