Abstract
The two principal methods involved in the serodiagnosis of Lyme borreliosis are the indirect immunofluorescence assay (IFA) and the indirect quantitative enzyme immunoassay (EIA). There is little data on their suitability for the follow-up of patients after therapy or their ability to define a cure. While IgM titers may be helpful indicators of active disease in the early stages, they are missed in most cases of late stage borreliosis. Patients included in a prospective randomized trial that compared cefotaxime against penicillin for the treatment of late Lyme borreliosis were serologically followed up over a twelve month period by the determination of IgG antibody titers, by IFA, EIA and Western blot. A significant decline of antibody titers in comparison with a control group of untreated patients was observed with the IFA, but not with the EIA, except for patients with Lyme arthritis. IFA titers declined by fourfold in the first three months after the onset of therapy, reaching a base-line of persistent antibody concentration. EIA titers, revealed only a small drop. Neither of the antibody tests proved to be suitable for indicating cure.
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