Seroprevalence and seroconversion of Lyme borreliosis among tick-bitten individuals: A multi-assay serosurveillance study

IF 3.4 2区医学 Q2 INFECTIOUS DISEASES

Ticks and Tick-borne Diseases Pub Date : 2026-03-01 Epub Date: 2026-02-13 DOI:10.1016/j.ttbdis.2026.102618

Rodanthi Zindrili , Malin Lager , Megan Simpson , Ayham Alnabulsi , Christopher J. Secombes , Anna Jonsson Henningsson , Robin Brittain-Long , Abdo Alnabulsi , Tiehui Wang , Per-Eric Lindgren

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引用次数: 0

Abstract

Lyme borreliosis (LB), caused by different species belonging to the Borrelia burgdorferi sensu lato group, is the most common tick-borne disease in Europe. However, its true burden remains difficult to assess, partly due to the diagnostic variability of commercial assays. This study evaluated seroprevalence and seroconversion following tick bite, using four serological assays with distinct antigenic compositions. Participants provided blood samples within three days of the tick bite and three months after to assess seroconversion. We evaluated the seroprevalence, seroconversion, inter-assay variation, consensus scoring, and factors affecting the detection rate for both seroprevalence and seroconversion.

Seroprevalence evaluation varied across the four serology assays: 33% using Anti-Borrelia plus VlsE (ABV), 26% using Epitogen™ Lyme (Epitogen), 22% using C6 Lyme ELISA (C6) and 10% using IDEIA™ B. burgdorferi (IDEIA). Estimation of overall seroconversion rates also differed: C6 had the highest rate (93%), followed by Epitogen (78%), ABV (58%) and IDEIA (38%). Using a consensus scoring approach that required positivity of at least two assays (including immunoblot) yielded a seropositivity rate of 23% at inclusion and an overall seroconversion rate of 86%. The Epitogen assay showed the highest level of concordance with the consensus score, followed by C6, ABV, and IDEIA assays.

Seroprevalence and seroconversion estimates in LB are highly assay-dependent. Assay choice significantly influenced outcome, mainly reflecting differences in antigen composition. This study underscores the importance of evaluating the antigen composition used in assays to ensure accurate result interpretation, particularly in the context of potential species variability across differing geographical regions. The use of consensus scoring across complementary multi-assays, or the implementation of well-designed assays with appropriate antigen coverage, offers a pathway to improved diagnostic accuracy and enhanced comparability.

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蜱叮咬个体莱姆病的血清阳性率和血清转化：一项多测定血清监测研究

莱姆病（Lyme borreliosis， LB）是欧洲最常见的蜱传疾病，由伯氏疏螺旋体（Borrelia sensu lato）属不同种引起。然而，其真正的负担仍然难以评估，部分原因是商业检测的诊断可变性。本研究评估了蜱叮咬后的血清阳性率和血清转化，使用四种具有不同抗原组成的血清学分析。参与者在蜱虫叮咬后三天内和三个月内提供血液样本，以评估血清转化。我们评估了血清阳性率、血清转化、测定间差异、共识评分以及影响血清阳性率和血清转化检出率的因素。四种血清学方法的血清阳性率评估各不相同：33%使用抗伯氏疏螺旋体+ VlsE (ABV)， 26%使用Epitogen™Lyme (Epitogen)， 22%使用C6 Lyme ELISA (C6)， 10%使用IDEIA™伯氏疏螺旋体（IDEIA）。总体血清转换率的估计也存在差异：C6的转换率最高（93%），其次是Epitogen（78%）、ABV（58%）和IDEIA（38%）。使用共识评分方法，需要至少两项检测（包括免疫印迹）的阳性，结果显示纳入时血清阳性率为23%，总血清转化率为86%。表原测定与一致评分的一致性最高，其次是C6、ABV和IDEIA测定。LB的血清阳性率和血清转化估计高度依赖于分析。测定方法的选择显著影响结果，主要反映抗原组成的差异。这项研究强调了评估检测中使用的抗原组成的重要性，以确保准确的结果解释，特别是在不同地理区域的潜在物种变异的背景下。在互补性多种检测中使用共识评分，或实施设计良好、抗原覆盖范围适当的检测，为提高诊断准确性和增强可比性提供了途径。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Ticks and Tick-borne Diseases INFECTIOUS DISEASES-MICROBIOLOGY

CiteScore

6.90

自引率

12.50%

发文量

185

审稿时长

6-12 weeks

期刊介绍： Ticks and Tick-borne Diseases is an international, peer-reviewed scientific journal. It publishes original research papers, short communications, state-of-the-art mini-reviews, letters to the editor, clinical-case studies, announcements of pertinent international meetings, and editorials. The journal covers a broad spectrum and brings together various disciplines, for example, zoology, microbiology, molecular biology, genetics, mathematical modelling, veterinary and human medicine. Multidisciplinary approaches and the use of conventional and novel methods/methodologies (in the field and in the laboratory) are crucial for deeper understanding of the natural processes and human behaviour/activities that result in human or animal diseases and in economic effects of ticks and tick-borne pathogens. Such understanding is essential for management of tick populations and tick-borne diseases in an effective and environmentally acceptable manner.