Introduction: Concerning the variety of clinical symptoms of Lyme disease, and their subsequent health consequences, serological diagnosis of Lyme disease requires an absolute confirmation of the presence of specific antibodies. The only use of the screening ELISA test, very sensitive but not specific, may lead to false-positive results. Use of the much more specific Western blot method, based on recombinant B. Burgdorferi antigens, increases the reliability of diagnosis.
Material and methods: The study included 354 positive sera in the ELISA screening test for the presence of IgG and/or IgM anti B. Burgdorferi antibodies. Positivity of sera was confirmed by Western blot, with specific recombinant antigens.
Results: The results varied significantly depending on the confirmed class of antibodies. The presence of specific antibodies against B. Burgdorferi was confirmed in about 79.4% of positive sera in ELISA for IgG class and in 34.2% for IgM class (Fig. 1). In both classes of antibodies (IgG and IgM), a correlation between the percentage of anti-Borrelia antibodies confirmed by Western blot and their level in the ELISA test was found (Fig. 2). Detailed analysis showed that the most common antibodies to recombinant antigens were VlsE (96.9%) in IgG class and OspC (96.8%) for genospecies of B. garinii and B. afzeliiin IgM class (Fig. 3).
Conclusions: The results were discussed regarding usefulness in the diagnosis and determination of the stage of possible infection of B. Burgdorferi. The reasons for the low (especially in IgM class) confirmation of positive results obtained in the ELISA screening method were also discussed.