Positive Lyme Serology Can Persist for Decades

Serologic testing (by ELISA and Western blot) for IgM and IgG antibodies to Borrelia burgdorferi is a mainstay of Lyme disease diagnosis. Specific IgM responses usually reflect recent exposure. New data show that serum can remain positive for both IgM and IgG Lyme antibodies decades after infection. Serology was performed on banked initial and follow-up sera from 79 individuals who were patients in the original Yale Lyme disease study during the late 1970s and early 1980s.

At presentation 10 to 20 years ago, 40 patients had early disease (localized or disseminated), and 39 had Lyme arthritis. At follow-up, no patient had active disease, and none had a history that suggested reinfection. Among the 40 early-disease patients, 88 percent of init…