Abstract
Objective: To use PCR based detection of B. burgdorferi to predict treatment response in Lyme neuroborreliosis.
Background: Accurate diagnosis of active Lyme neuroborreliosis has been difficult, contributing to difficulty judging treatment efficacy.
Design/Methods: Forty-nine patients with immunologic evidence of exposure to B. burgdorferi, and nervous system symptoms consistent with this diagnosis, underwent lumbar puncture and were treated with ceftriaxone. Using previously described techniques, intrathecal antibody production (ITAb) was measured, and CSF was probed for B. burgdorferi-specific DNA. Response to treatment was judged clinically, with 1–4 year follow-up. Response was assessed prior to performing PCR assays, and was judged as complete, partial, or failure.
Results: (i) 19 patients failed to respond; 11 were PCR -, 8 PCR+. (ii) 22 patients responded partially; 19 were PCR+. (iii) 8 patients recovered completely; 5 were PCR+, 3 PCR-. The association between PCR positivity and treatment response was highly statistically significant (p=0.005, Chi-squared test).
Conclusion: PCR based detection of B. burgdorferi genetic material predicts treatment responsiveness in patients with appropriate nervous system symptoms. False negatives may occur; treatment failures may reflect inadequate treatment or false positive results.
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© 1994 Springer Science+Business Media New York
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Halperin, J., Keller, T., Whitman, M. (1994). PCR-Based Detection of Csf Borrelia Burgdorferi as a Predictor of Treatment Response in CNS Lyme Borreliosis. In: Axford, J.S., Rees, D.H.E. (eds) Lyme Borreliosis. NATO ASI Series, vol 260. Springer, Boston, MA. https://doi.org/10.1007/978-1-4615-2415-1_42
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DOI: https://doi.org/10.1007/978-1-4615-2415-1_42
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