Oteo Revuelta J A, Elías Calvo C, Martínez de Artola V, Pérez Surribas D
Servicio de Medicina Interna, Hospital de La Rioja, Logroño.
Med Clin (Barc). 1993 Jul 3;101(6):207-9.
Given that Lyme's disease and HIV infection may present with similar clinical symptoms and that the serologic tests for the determination of antibodies against Borrelia burgdorferi present frequent false positives, the presence of antibodies against B. burgdorferi in patients with HIV in different evolutive stages was studied.
Antibodies against B. burgdorferi were determined by IFI and ELISA in a serum sample of 72 individuals with HIV. Western blot (WB) against B. burgdorferi was performed in the sera which were positive by one method or the other. The presence of antiphospholipid antibodies was also studied.
A total of 24 sera (33%) were positive by IFI and/or ELISA. Twenty-one (29%) by IFI and 7 (10%) by ELISA (chi 2; p = 0.006). Four (5.5%) were positive by both methods. Only one of the sera was positive by IFI, ELISA and WB. No statistical relation was found upon comparison of the positive results against B. burgdorferi with the different evolutive stages of HIV infection or with the presence of antiphospholipid antibodies.
The high prevalence of false positive serology to B. burgdorferi in the collective of patients with the human immunodeficiency virus infection together with the possibility of presenting similar clinical manifestations has led to extreme prudence in the diagnosis of infection by B. burgdorferi in patients with HIV infection.
鉴于莱姆病和HIV感染可能呈现相似的临床症状，且用于检测抗伯氏疏螺旋体抗体的血清学检测经常出现假阳性，因此对处于不同演变阶段的HIV患者体内抗伯氏疏螺旋体抗体的存在情况进行了研究。
采用间接荧光免疫法（IFI）和酶联免疫吸附测定法（ELISA）对72例HIV患者的血清样本进行抗伯氏疏螺旋体抗体检测。对通过其中一种方法检测为阳性的血清进行伯氏疏螺旋体免疫印迹法（WB）检测。同时也研究了抗磷脂抗体的存在情况。
共有24份血清（33%）通过IFI和/或ELISA检测呈阳性。其中21份（29%）通过IFI检测呈阳性，7份（10%）通过ELISA检测呈阳性（卡方检验；p = 0.006）。4份（5.5%）通过两种方法检测均呈阳性。仅1份血清通过IFI、ELISA和WB检测均呈阳性。将抗伯氏疏螺旋体抗体检测的阳性结果与HIV感染的不同演变阶段或抗磷脂抗体的存在情况进行比较时，未发现统计学关联。
人类免疫缺陷病毒感染患者群体中抗伯氏疏螺旋体血清学检测假阳性的高发生率，以及可能出现相似临床表现，使得在诊断HIV感染患者的伯氏疏螺旋体感染时需极为谨慎。
