WHAT TESTS ARE AVAILABLE?
A variety of tests is available. Many doctors who are unfamiliar with Lyme disease just use the Lyme test
available in their local laboratory. This is usually the Lyme ELISA. This test measures a patient’s anti-
body, IgM and/or IgG, in response to exposure to the Lyme bacteria. By today’s standards, these tests
are not very sensitive. IGeneX, Inc. will only perform the ELISA test in conjunction with Western Blots.
The Lyme IFA (performed as part of a Lyme Panel) detects IgG, IgM and IgA antibodies against
B. burgdorferi. IgM-specific titers usually persist in the presence of disease. Antibody levels tend to
rise above background levels about 2-3 weeks after infection and may remain elevated in case of
prolonged disease.
The WESTERN BLOT tests (IgG and/or IgM) visualizes the exact antibodies you are making to the Lyme
bacteria. In some cases, the laboratory may be able to say that your “picture of Lyme antibodies” is
consistent with early disease or with persistent and/or recurrent disease. Not all patients have anti-
bodies at all times when tested. Antibodies are more commonly detected within the first year after
infection, although re-infection may cause a significant rebirth of antibodies. At most, only 70% of
patients have antibodies early, and the presence of antibodies alone does not make a diagnosis of
disease.
The LYME DOT BLOT ASSAY (LDA) looks for the presence of pieces of the Lyme bacteria in urine.
The assay specificity is better than 90%.
The PCR (Polymerase Chain Reaction) test, a highly specific and sensitive test detects the presence of
the DNA of the Lyme bacteria. The PCR test is often the only marker that is positive in all stages of Lyme
disease. The test can be performed on blood, serum, urine, CSF and miscellaneous fluids/tissues.
Unfortunately, Lyme bacteria like to “hide” in the body, therefore, PCR can often be negative. Studies
performed on different sample types suggest that performing PCR on multiple sample types improves
assay sensitivity. In the Lyme Panels, PCR on whole blood is performed as a courtesy when PCR on
serum is ordered. This gives the panel 80% sensitivity.