LDA/Columbia 2011
Scientific Conference

Hyatt Penns Landing

Philadelphia, PA

October 1-2, 2011

Category:  Lyme testing (blood, spinal fluid...)

Can you have Lyme disease without any symptoms? I had blood work that showed I have Lyme but I don't have any symptoms.

If a person doesn't have signs or symptoms of Lyme disease, then the person does not have Lyme disease as the definition of disease requires symptoms. A blood test may be positive for several reasons. First, the positive test may indicate that the person was infected previously by the agent of Lyme disease and the immune system mounted a successful attack which resulted in the long-term production of antibodies against the agent of Lyme disease. That's why tests can stay positive for months to years, even when active infection is no longer present. We expect, however, that over time the ELISA titer should decrease in magnitude. Second, a positive test may also indicate that there is a small amount of persistent infection that is continuing to partially stimulate the immune system. The residual organism may not be biologically active; i.e., it might be in a latent or dormant state and thus not causing any disease symptoms. In this case, the ELISA titer may stay elevated for long periods without a gradual decline. Third, a positive test may be a false positive, especially if the positive test is only an ELISA. It is well known for example that concurrent viral infections (such as Epstein-Barr) may result in a false positive Lyme ELISA. If the positive test is an IgG Western blot or a C6 Lyme ELISA, it is very unlikely that either test would be falsely positive. Fourth, a positive test may indicate that you did have some of the signs or symptoms of Lyme disease in the past but didn't recognize the problem as Lyme disease. You may have then been treated with antibiotics for another reason and this may have led to a resolution of the Lyme disease without your awareness of ever having had Lyme disease.

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