The diagnostic value of serum Borrelia burgdorferi antibodies and seroconversion after Lyme neuroborreliosis, a nationwide observational study. (November 2022)

• Record Type: Journal Article
• Authors: Tetens, Malte M.; Dessau, Ram; Ellermann-Eriksen, Svend; Andersen, Nanna S.; Jørgensen, Charlotte Sværke; Østergaard, Christian; Bodilsen, Jacob; Damgaard, David F.; Bangsborg, Jette; Nielsen, Alex Christian; Møller, Jens Kjølseth; Omland, Lars Haukali; Obel, Niels; Lebech, Anne-Mette
• Is Part Of: Clinical microbiology and infection. Volume 28:Number 11(2022)
• Page Start: 1500.e1
• Page End: 1500.e6
• Publication Date: 2022-11
• Subjects: Borrelia burgdorferi intrathecal antibody index test -- Diagnostics -- Lyme neuroborreliosis -- Predictive value -- Seroconversion -- Serum antibody test -- Serum serology; Medical microbiology -- Periodicals; Diagnostic microbiology -- Periodicals; Communicable diseases -- Periodicals; Infection -- Periodicals; 616.01
• DOI: 10.1016/j.cmi.2022.06.001
• Languages: English
• ISSNs: 1198-743X

Abstract

Abstract: Objectives: Clinical guidelines disagree on the diagnostic usefulness of Borrelia burgdorferi ( Bb ) serum antibodies (serum- Bb) in investigation of Lyme neuroborreliosis (LNB) . We investigated the association between serum- Bb and Bb intrathecal antibody index ( Bb -AI) and rates of seroconversion and seroreversion after LNB. Methods: Danish residents who had a Bb -AI and corresponding serum- Bb measured between 1994 and 2020 were identified at all Danish departments of clinical microbiology. We used descriptive statistics to examine the proportions of positive Bb -AI combined with positive or negative serum- Bb antibody tests. Next, the rate of seroconversion and seroreversion among those with positive Bb- AI and either an initial negative or positive serum- Bb was estimated. Results: We included 34 609 individuals with a Bb -AI and corresponding serum- Bb . The proportion of individuals with positive Bb -AI who had negative serum- Bb was 16.8% (95% CI, 15.1–18.6). The proportion of individuals with positive serum- Bb IgM, serum- Bb IgG, or serum- Bb IgM and IgG antibodies who had positive Bb -AI was 10.6% (95% CI, 9.5–11.8), 24.7% (95% CI, 23.0–26.4), and 45.0% (95% CI, 42.4–48.0), respectively. The proportion of children (<18 years) with positive serum- Bb IgM and IgG antibodies who had a positive Bb -AI was 59.7% (95% CI, 53.4–65.8). The proportion of individuals with positive Bb- AI with initial negative or positive serum- Bb antibodies who seroconverted or seroreverted within 2 years was 17.3% (95% CI, 6.9–27.8) and 23.2% (95% CI, 19.1–27.7), respectively. Conclusions: Serum- Bb antibodies could not predict results of Bb- AI. A fifth of both seronegative and seropositive individuals with positive Bb- AI seroconverted or seroreverted within 2 years.