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C₆ Test as an Indicator of Therapy Outcome for Patients with Localized or Disseminated Lyme Borreliosis

Division of Bacteriology and Parasitology, Tulane National Primate Research Center, Tulane University Health Sciences Center, Covington, Louisiana,¹ Laboratory of Clinical Investigation, National Institute of Allergy and Infectious Diseases, National Institutes of Health, Bethesda,² The EMMES Corporation, Rockville, Maryland,⁴ Alfred I. duPont Hospital for Children, Wilmington, Delaware³

Received 13 February 2003/ Returned for modification 27 May 2003/ Accepted 18 August 2003

Management of Lyme disease would benefit from a test to assess therapy outcome. Such a test could be employed to ascertain if treatment of early Lyme disease was successful and would be helpful to clinicians assessing patients with lingering posttreatment symptoms. We reported recently that levels of the antibody to C₆, a Borrelia burgdorferi-derived peptide that is used as an antigen in the C₆-Lyme diagnostic test, declined after successful antibiotic treatment of Lyme borreliosis patients. We assessed retrospectively the change in anti-C₆ antibody titers in 131 patients with either early localized disease (erythema migrans) or disseminated disease. All of these patients were treated with antibiotics and were free of the clinical signs shown at presentation within 12 weeks after the initiation of treatment. Decreases in reciprocal geometric mean titers (rGMT) of the anti-C₆ antibody were quantified for the subpopulation of 45 patients whose baseline rGMT were 80 and whose second serum specimens were obtained at least 6 months after the baseline specimen. Eighty percent of this patient group (36 of 45) experienced a 4-fold decrease in their rGMT (P < 0.0003). These results suggest that a change in the anti-C₆ antibody titer may serve as an indicator of therapy outcome for patients with localized or disseminated Lyme borreliosis.

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