The Western blot test has been part of the two-step testing system since 1994 and is more commonly used. One is called a Western blot, which looks at how your antibodies react to specific parts of the Lyme disease bacteria. There are two options for the second test. The second test: Western Blot or a second ELISA Because it can take some time for your body to produce antibodies, this test isn’t always accurate soon after a person is infected. This blood test is for antibodies against the Lyme disease bacteria. The first test: ELISA (enzyme-linked immunosorbent assay) Using today’s tests it is difficult to distinguish between current and previous infections, so if you were previously diagnosed with Lyme disease and may have been re-infected, your doctor should make the diagnosis based on your symptoms and risk factors. In some cases, a Lyme test may not be helpful. If you think you may have Lyme disease, but your doctor hasn’t considered it or has ruled it out before testing you for it, here’s how you can start a conversation: Give your doctor a list of Lyme disease symptoms and risk factors, and ask them if, given your own symptoms and risk factors, Lyme disease could be a possible cause and whether you should be tested. If you have been traveling, your doctor might test you for species of Borrelia that cause Lyme disease in other parts of the world. Your doctor may also do tests to see if other conditions with similar or overlapping symptoms - for example, thyroid disease, autoimmune disease, or other tick-borne diseases - could be causing your symptoms. Laboratory tests can support a clinical diagnosis, but should not be used on their own to confirm or rule out a current Lyme disease diagnosis. Your doctor will consider whether your symptoms and risk factors suggest Lyme disease when deciding whether you need a Lyme test. By that time, Lyme disease is harder to treat, and long-term complications are more likely, so an early, accurate diagnosis is very important. That’s why Lyme disease cases may be missed, and as many as 40% of Lyme disease cases are not diagnosed until a later stage of the disease. Using today’s tests, it is difficult to distinguish between an old Lyme disease infection and a new one. This may result in Lyme diagnoses being missed because symptoms are attributed to another illness. Symptoms of Lyme disease like fever and body aches can also be caused by other illnesses. It is also possible that a person may not notice a rash before it goes away. But up to 30% of people who get Lyme disease never get a rash. The only sure sign of Lyme disease is an erythema migrans (EM) rash, which often has a bullseye shape. That’s because Lyme tests look for proteins created by your immune system to help you fight off infection (antibodies), rather than for the infection itself, and it can take a few weeks for your body to make enough antibodies to cause a positive test. Tests are less accurate for a short period of time after you first become infected. A clinician’s test selection and interpretation, diagnosis, and patient management decisions should be based on his/her education, clinical expertise, and assessment of the patient.There are several reasons it can be hard to diagnose Lyme disease. This FAQ is provided for informational purposes only and is not intended as medical advice. Performance of the Focus and Kalon enzyme-linked immunosorbent assays for antibodies to herpes simplex virus type 2 glycoprotein G in culture-documented cases of genital herpes. Detection of herpes simplex virus type 2-specific immunoglobulin G antibodies in African sera by using recombinant gG2, Western blotting, and gG2 inhibition. Herpes simplex virus type 2 (HSV-2) IgG index values in two immunoassays in relation to HSV-2 IgG inhibition assay results. Inhibition values >60% indicate true HSV-2-specific IgG reactivity Index value for serum pre-incubated with HSV-1 lysate = 2.45 Index value for serum pre-incubated with HSV-2 lysate = 0.23 An example of how the inhibition value is calculated is shown below: The HSV-1 lysate controls for any non-gG2 reactivity present in the serum sample thus, any inhibition that is detected reflects only the absorption of gG2 reactive antibodies by the native gG2 present in the HSV-2 lysate. The index value of serum pre-incubated with HSV-2 lysate is then compared to the index value of serum pre-incubated with HSV-1 lysate. 2 Separate aliquots of the patient sample are incubated with the 2 lysates, then tested in the HerpeSelect HSV-2 type-specific IgG ELISA. The HSV-2 IgG inhibition assay measures the differential abilities of lysates of cells infected with HSV-1 or HSV-2 to neutralize patient sample reactivity to recombinant gG2 protein (rgG2), the HSV-2–specific protein used in the HerpeSelect HSV-2 IgG ELISA.
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