The diagnostic value of serum Borrelia burgdorferi antibodies and seroconversion after Lyme neuroborreliosis, a nationwide observational study
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The diagnostic value of serum Borrelia burgdorferi antibodies and seroconversion after Lyme neuroborreliosis, a nationwide observational study. / Tetens, Malte M.; Dessau, Ram; Ellermann-Eriksen, Svend; Andersen, Nanna S.; Jørgensen, Charlotte Sværke; Østergaard, Christian; Bodilsen, Jacob; Damgaard, David F.; Bangsborg, Jette; Nielsen, Alex Christian; Møller, Jens Kjølseth; Omland, Lars Haukali; Obel, Niels; Lebech, Anne Mette.
I: Clinical Microbiology and Infection, Bind 28, Nr. 11, 2022, s. 1500.e1-1500.e6.Publikation: Bidrag til tidsskrift › Tidsskriftartikel › Forskning › fagfællebedømt
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T1 - The diagnostic value of serum Borrelia burgdorferi antibodies and seroconversion after Lyme neuroborreliosis, a nationwide observational study
AU - Tetens, Malte M.
AU - Dessau, Ram
AU - Ellermann-Eriksen, Svend
AU - Andersen, Nanna S.
AU - Jørgensen, Charlotte Sværke
AU - Østergaard, Christian
AU - Bodilsen, Jacob
AU - Damgaard, David F.
AU - Bangsborg, Jette
AU - Nielsen, Alex Christian
AU - Møller, Jens Kjølseth
AU - Omland, Lars Haukali
AU - Obel, Niels
AU - Lebech, Anne Mette
N1 - Publisher Copyright: © 2022 European Society of Clinical Microbiology and Infectious Diseases
PY - 2022
Y1 - 2022
N2 - Objectives: Clinical guidelines disagree on the diagnostic usefulness of Borrelia burgdorferi (Bb) serum antibodies (serum-Bb) in investigation of Lyme neuroborreliosis (LNB). We investigated the association between serum-Bb and Bb intrathecal antibody index (Bb-AI) and rates of seroconversion and seroreversion after LNB. Methods: Danish residents who had a Bb-AI and corresponding serum-Bb measured between 1994 and 2020 were identified at all Danish departments of clinical microbiology. We used descriptive statistics to examine the proportions of positive Bb-AI combined with positive or negative serum-Bb antibody tests. Next, the rate of seroconversion and seroreversion among those with positive Bb-AI and either an initial negative or positive serum-Bb was estimated. Results: We included 34 609 individuals with a Bb-AI and corresponding serum-Bb. The proportion of individuals with positive Bb-AI who had negative serum-Bb was 16.8% (95% CI, 15.1–18.6). The proportion of individuals with positive serum-Bb IgM, serum-Bb IgG, or serum-Bb IgM and IgG antibodies who had positive Bb-AI was 10.6% (95% CI, 9.5–11.8), 24.7% (95% CI, 23.0–26.4), and 45.0% (95% CI, 42.4–48.0), respectively. The proportion of children (<18 years) with positive serum-Bb IgM and IgG antibodies who had a positive Bb-AI was 59.7% (95% CI, 53.4–65.8). The proportion of individuals with positive Bb-AI with initial negative or positive serum-Bb antibodies who seroconverted or seroreverted within 2 years was 17.3% (95% CI, 6.9–27.8) and 23.2% (95% CI, 19.1–27.7), respectively. Conclusions: Serum-Bb antibodies could not predict results of Bb-AI. A fifth of both seronegative and seropositive individuals with positive Bb-AI seroconverted or seroreverted within 2 years.
AB - Objectives: Clinical guidelines disagree on the diagnostic usefulness of Borrelia burgdorferi (Bb) serum antibodies (serum-Bb) in investigation of Lyme neuroborreliosis (LNB). We investigated the association between serum-Bb and Bb intrathecal antibody index (Bb-AI) and rates of seroconversion and seroreversion after LNB. Methods: Danish residents who had a Bb-AI and corresponding serum-Bb measured between 1994 and 2020 were identified at all Danish departments of clinical microbiology. We used descriptive statistics to examine the proportions of positive Bb-AI combined with positive or negative serum-Bb antibody tests. Next, the rate of seroconversion and seroreversion among those with positive Bb-AI and either an initial negative or positive serum-Bb was estimated. Results: We included 34 609 individuals with a Bb-AI and corresponding serum-Bb. The proportion of individuals with positive Bb-AI who had negative serum-Bb was 16.8% (95% CI, 15.1–18.6). The proportion of individuals with positive serum-Bb IgM, serum-Bb IgG, or serum-Bb IgM and IgG antibodies who had positive Bb-AI was 10.6% (95% CI, 9.5–11.8), 24.7% (95% CI, 23.0–26.4), and 45.0% (95% CI, 42.4–48.0), respectively. The proportion of children (<18 years) with positive serum-Bb IgM and IgG antibodies who had a positive Bb-AI was 59.7% (95% CI, 53.4–65.8). The proportion of individuals with positive Bb-AI with initial negative or positive serum-Bb antibodies who seroconverted or seroreverted within 2 years was 17.3% (95% CI, 6.9–27.8) and 23.2% (95% CI, 19.1–27.7), respectively. Conclusions: Serum-Bb antibodies could not predict results of Bb-AI. A fifth of both seronegative and seropositive individuals with positive Bb-AI seroconverted or seroreverted within 2 years.
KW - Borrelia burgdorferi intrathecal antibody index test
KW - Diagnostics
KW - Lyme neuroborreliosis
KW - Predictive value
KW - Seroconversion
KW - Serum antibody test
KW - Serum serology
U2 - 10.1016/j.cmi.2022.06.001
DO - 10.1016/j.cmi.2022.06.001
M3 - Journal article
C2 - 35709901
AN - SCOPUS:85137643022
VL - 28
SP - 1500.e1-1500.e6
JO - Clinical Microbiology and Infection
JF - Clinical Microbiology and Infection
SN - 1198-743X
IS - 11
ER -
ID: 322953170