We compared the antibodies to B. burgdorferi in three different populations
in order to evaluate the diagnostic reliability of Lyme borreliosis serolo
gic analysis. The subjects included 25 patients with Lyme borreliosis (Grou
p 1); 50 patients with diseases of unknown cause, B. burgdorferi ELISA-posi
tive in serum and without B. burgdorferi infection (Group 2); and 1,251 ind
ividuals without Lyme borreliosis (Group 3). All samples were tested for B,
burgdorferi B31 and B. afzelii antigens using ELISA. The positive results
of the ELISA B. burgdorferi B31 assay were confirmed with Western blot for
the same strain. In Group 3, 162 (12.9%) patients were ELISA positive for B
. burgdorferi B31, while only 6 (0.6%) patients had IgG ELISA antibodies to
B afzeiii. Bands in WE were detected in 104 (8.4%) of the Group 3 subjects
. The bands found to be most reliable for the identification of strain B. b
urgdorferi B31 by IgG WE were those representing the 93, 39, 34, and 23-kDa
proteins. Our results show that serologic diagnosis of Lyme borreliosis is
far from clearly established. To date, the only reliable criteria are clin
ical ones correlated with laboratory evidence. (C) 2000 Wiley-Liss, Inc.