Antibody response in infections with Borrelia burgdorferi sensu lato is generally considered to be slow and delayed, but exact studies concerning this question are hardly found in the scientific literature. During 1994-1998 at least two serum samples were submitted for serological testing from more than 1200 patients. An immunofluorescence test was performed paralelly with two pools of antigen (B. bg.s.s. + B. afzelii, and two serological different strains of B. garinii, all of local origin). In 92-96% of patients no change of antibody level was found in repeated tests, about 20% of them being negative (< 1:512). In 2-4% of cases a significant increase and in less than 1% a decrease or a second wave of the rise of the antibody level was observed. From the 58 patients with increasing antibody levels 9 had ECM (mostly children), 2 cardiovascular, 8 musculo-skeletal and 12 neurological disorders. In the remaining cases the diagnosis was not specified (A 69). Only in 9 cases a rise of the titer appeared during 3 weeks after the first negative sample, at contrary in 7 cases no rise of the titer was seen in that time. 2 patients were still after 1 month, 3 after 3 months and 1 even after 7 months (patient with a positive CSF culture) serologically negative. A 2 titer step decrease was observed in 4 cases during 1 year and once a 3 titer decrease after 4 years.
Conclusion: A rise of antibodies can be seen in all clinical manifestations of Lyme disease with prevalence in the early types of the disease. The rise of antibodies is often delayed or even inhibited, apparently mostly by an early efficient treatment. Whether a late rise of antibodies or its long persistence indicates a latency of the infection, requires more detailed studies. (Tab. 5, Ref. 6.)