Serologic testing is the standard for laboratory diagnosis and confirmation of
Lyme disease. Serodiagnostic assays to detect
antibodies against Borrelia burgdorferi, the agent of
Lyme borreliosis, are used for detection of
infection. However, serologic testing within the first month of
infection is less sensitive as patients' antibody responses continue to develop. Previously, we screened several B. burgdorferi in vivo expressed
antigens for candidates that elicit early antibody responses in patients with Stage 1 and 2
Lyme disease. We evaluated patient
IgM seroreactivity against 6
antigens and found an increase in sensitivity without compromising specificity when compared to current
IgM second-tier immunoblot scoring. In this study, we continued the evaluation using a multi-
antigen panel to measure
IgM plus
IgG seroreactivity in these early
Lyme disease patients' serum samples. Using two statistical methods for calculating positivity cutoff values, sensitivity was 70 and 84-87%, for early acute and early convalescent
Lyme disease patients, respectively. Specificity was 98-100% for healthy non-endemic control patients, and 96-100% for healthy endemic controls depending on the statistical analysis. We conclude that improved serologic testing for early
Lyme disease may be achieved by the addition of multiple borrelial
antigens that elicit
IgM and
IgG antibodies early in
infection.