Simple Test for Lyme May Be More Effective Than Current Guidelines

Testing for an increased cluster of differentiation 4 (CD4)/CD8 ratio and a positive immunoglobulin G (IgG) band 41 may diagnose Lyme disease more effectively than current guidelines, according to a recent study.

Findings from the study were presented by Dr Harpal S. Mangat on August 22, 2017, at the 3rd Annual Congress on Infectious Diseases in San Francisco, California.
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Laboratory testing, when performed correctly with previously validated methods, is helpful in diagnosing Lyme disease. For a positive Lyme diagnosis, the US Centers for Disease Control and Prevention (CDC) diagnostic criteria requires the identification of 5 Western blot IgG bands. However, some patients who demonstrate less than 5 positive bands are still subsequently diagnosed with Lyme disease via Nanotrap polymerase chain reaction (PCR) urine testing.

In order to test the accuracy of a simpler method for diagnosing Lyme disease, Dr Mangat and colleagues assessed 183 patients at 2 medical centers located in Lyme-endemic communities in Maryland. A total of 148 patients were evaluated via one- and two-tailed testing for correlations between CD4/CD8 ratios and IgG band 41. In the United States, a CD4/CD8 ratio between 0.9 and 1.9 is considered normal in non-immunocompromised individuals.

Results indicated that testing for an increased CD4/CD8 ratio with a positive IgG band 41 was effective for diagnosing Lyme disease, compared with current guidelines. The mean CD4/CD8 ratio was 2.41 among the 148 patients tested.

To further confirm the efficacy of this method, 2 patients who were IgG 41 positive and had initial CD4/CD8 ratios of 2.7 and 2.8 also underwent Nanotrap PCR urine testing. Both patients subsequently received a positive diagnosis for Lyme disease.

“Increased CD4/CD8 ratio with a positive IgG 41 band appears to be a strong predictor of a subsequent diagnosis of Lyme disease despite current diagnostic guidelines,” Dr Mangat concluded. “Further research should not only be directed toward investigating how Borrellia burgdoferi disrupts immune function, but also toward improving diagnostic guidelines in light of validated diagnostic methods.”

—Christina Vogt

Reference:

Mangat HS. Correlation of Lyme disease with immune dysfunction. Paper presented at: 3rd Annual Congress on Infectious Diseases; August 21-23, 2017. San Francisco, CA.  http://infection.conferenceseries.com/abstract/2017/correlation-of-lyme-disease-with-immune-dysfunction.