What is the significance of Lyme total antibody (Lyme disease antibody) test results?

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Last updated: April 10, 2025View editorial policy

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From the Guidelines

The Lyme Total Antibody CIA should be used as an initial screening test for Lyme disease, followed by a Western blot or immunoblot for confirmation, as recommended by current guidelines 1. When interpreting the results of the Lyme Total Antibody CIA, it is essential to consider the clinical presentation and timing of illness, as the sensitivity of the test is low (30%–40%) during early infection, but higher (70%–100%) for disseminated Lyme disease 1.

  • The test measures both IgM and IgG antibodies in a single assay, making it a comprehensive screening tool for Lyme infection.
  • The CIA methodology offers improved sensitivity and specificity compared to older testing methods, potentially reducing false negatives in early infection.
  • However, antibodies may not be detectable until several weeks after infection, so a negative result doesn't necessarily rule out recent infection.
  • If the total antibody test is positive, follow-up testing with a Western blot or immunoblot is usually recommended to confirm the diagnosis before initiating treatment, as seroreactivity alone cannot be used as a marker of active disease 1.
  • This two-tier testing approach helps distinguish true Lyme infections from false positives that can occur due to cross-reactivity with other conditions.
  • It is also important to note that repeated infection with B. burgdorferi has been reported, and neither positive serologic test results nor a history of previous Lyme disease ensures that a person has protective immunity 1.

From the Research

Lyme Total Antibody CIA

  • The provided studies do not directly address the topic of Lyme total antibody CIA.
  • However, the studies discuss the diagnosis and treatment of Lyme disease, which may be related to the topic of Lyme total antibody CIA.
  • According to 2, cefuroxime axetil and amoxicillin are effective treatments for children with early Lyme disease.
  • The study 3 discusses the treatment of Lyme disease, including the use of oral antibiotics such as amoxicillin and doxycycline for early stages of the disease.
  • The review 4 details the risk factors, clinical presentation, treatment, and prophylaxis for Lyme disease, including the use of doxycycline or amoxicillin for treatment.
  • The study 5 discusses the efficiency of antibiotics in treating erythema migrans, the hallmark of early stage Lyme borreliosis, and notes that oral amoxicillin and doxycycline are first-line treatment options.
  • The retrospective cohort study 6 reports the long-term clinical outcomes of patients with early localized and early disseminated Lyme disease based on the duration of antibiotic therapy prescribed, and finds that patients treated for 10 days with antibiotic therapy have long-term outcomes similar to those of patients treated with longer courses.

References

Guideline

Guideline Directed Topic Overview

Dr.Oracle Medical Advisory Board & Editors, 2025

Research

Diagnosis and treatment of Lyme disease.

Mayo Clinic proceedings, 2008

Research

Treatment and prevention of Lyme disease.

Current problems in dermatology, 2009

Research

Antibiotic treatment duration and long-term outcomes of patients with early lyme disease from a lyme disease-hyperendemic area.

Clinical infectious diseases : an official publication of the Infectious Diseases Society of America, 2010

Professional Medical Disclaimer

This information is intended for healthcare professionals. Any medical decision-making should rely on clinical judgment and independently verified information. The content provided herein does not replace professional discretion and should be considered supplementary to established clinical guidelines. Healthcare providers should verify all information against primary literature and current practice standards before application in patient care. Dr.Oracle assumes no liability for clinical decisions based on this content.

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