SENSITIVITY AND SPECIFICITY OF THE BORRELIACIDAL-ANTIBODY TEST DURINGEARLY LYME-DISEASE - A GOLD STANDARD

The serodiagnosis of early Lyme disease has been plagued with problems of sensitivity and specificity. We found that the flow-cytometric bor reliacidal-antibody test had a sensitivity of 72% for the detection of patients with early Lyme disease. By contrast, the sensitivity of the enzyme immunofluorescence assay was 28%, The enhanced sensitivity of the borreliacidal-antibody test was due to the use of Borrelia burgdor feri 50772, which lacks OspA and OspB. When B. burgdorferi 297, which expresses both OspA and OspB, was used, the sensitivity of the borreli acidal-antibody test was 15%. Our results also showed that the borreli acidal-antibody test was specific. No borreliacidal activity was detec ted in normal sera or in sera from patients with mononucleosis, rheuma toid factor, or syphilis. These results demonstrate that the flow-cyto metric borreliacidal-antibody test may be the laboratory ''gold standa rd'' for the serodiagnosis of Lyme disease.