Chronic Lyme disease is predominantly a clinical diagnosis. Lab tests are used to back up the clinical impression and positively identify the presence of Lyme disease and co-infections.
ELISA
First test done as screening test. ELISA is measuring an immune reaction but is not highly sensitive – most cases missed. A negative ELISA test does not rule out Lyme disease. This is not considered to be a sensitive test.
PCR
Looks for DNA of bacteria in blood. Can do for borrelia and all coinfections. Specific, but not highly sensitive.
Western Blot
Looks at IgM (active, current infection) and IgG (longer term, more chronic infection or past exposure).
Certain bands are significant – IgeneX recognizes certain bands that the CDC does not.
Need a certain number of bands to be present to make a positive result – but even one Lyme-specific band may indicate infection (hence need clinical picture)
FISH Tests
Babesia and bartonella. These are smear tests where they stain the sample and see the bugs glowing in the dark!
Antibody Tests
For babesia, bartonella, rickettsia, erlichia. IgG and IgM.
CD-57
Immune marker that is suppressed in Lyme disease. Can be used to track progress of treatment over time, but not a perfect science. Available in Australia/ do not run through IGeneX.
Running multiple tests increases the likelihood of making an accurate diagnosis.