Early detection and persistence of antibodies to Borrelia burgdorferi in persons with Lyme disease.

An indirect immunofluorescence antibody (IFA) test and an enzyme-linked immunosorbent assay (ELISA) were used during 1984 to detect total immunoglobulins (Ig) or IgM and IgG antibodies to Borrelia burgdorferi. Of the 139 serum samples tested by IFA, representing 110 persons with erythema chronicum migrans (ECM), 84 (60%) had either or both class-specific immunoglobulins. Serologic confirmation was made for 64 (58%) patients; serum specimens from 54 (49%) of these had elevated levels of IgM antibodies. These immunoglobulins were usually present within 14 days after diagnosis of ECM and persisted for at least 30 days. Significant titers of IgG antibodies were recorded for 54 serum samples and remained elevated for at least 19 weeks after ECM was first observed. When utilizing polyvalent (Ig) conjugates, ELISA procedures verified antibody presence in 80 of the 84 serum samples positive by IFA. Similarly, samples negative in IFA tests were non-reactive by ELISA. Additional tests of 40 control samples, obtained from persons without Lyme disease, were also uniformly negative. Both methods were suitable for confirmation of Lyme disease infections.