EVALUATION OF 9 SEROLOGICAL TESTS FOR DIAGNOSIS OF LYME-BORRELIOSIS

Two hundred serum specimens including 13 sera from patients with early Lyme borreliosis, 21 patients with late Lyme borreliosis, 15 rheumato id factor positive sera, 31 sera from patients with syphilis and 84 se ra from healthy controls were used to evaluate the following assays fo r the detection of antibodies to Borrelia burgdorferi: two in-house en zyme immunoassays (EIAs), two in-house immunofluorescent antibody assa ys (IFAs), a commercial haemagglutination assay (HA) (Diagast) and fou r commercial EIAs (Diagast, Dako, Diamedix, Whittaker Bioproducts). In early and late Lyme borreliosis sera sensitivity ranged from 8 % to 6 2 % and from 62 % to 86 % respectively. With the exception of the Dako EIA, which was significantly more sensitive in early Lyme borreliosis (62 %) than the Diagast HA (8 %) (p = 0.05), differences in sensitivi ty were not significant. In healthy controls the specificity was great er than or equal to 95 % for all tests. Taking into account sensitivit y, specificity, intra-test and inter-test precision, ease of performan ce and cost, the Dako EIA and Diamedix EIA were shown to be good alter natives to the in-house EIA and in-house IFA. Because of its low sensi tivity in diagnosis of both early and late Lyme borreliosis, use of th e Diagast HA should be discouraged.