Real-world Lyme disease testing results using modified vs standard two-tier test protocols.

The modified two-tier test (MTTT) and standard two-tier test (STTT) protocols are being used for Lyme disease serology testing in the clinic. We aimed to compare the real-world testing results of MTTT, a recently approved protocol, vs STTT, a mainstay protocol over the past decades. To this end, we...

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Main Authors: Yonghong Li, Zhen Chen, Carmen H Tong, Ky Van, Robert S Jones, Lance A Bare
Format: Article
Language:English
Published: Public Library of Science (PLoS) 2025-01-01
Series:PLoS ONE
Online Access:https://doi.org/10.1371/journal.pone.0327376
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author Yonghong Li
Zhen Chen
Carmen H Tong
Ky Van
Robert S Jones
Lance A Bare
author_facet Yonghong Li
Zhen Chen
Carmen H Tong
Ky Van
Robert S Jones
Lance A Bare
author_sort Yonghong Li
collection DOAJ
description The modified two-tier test (MTTT) and standard two-tier test (STTT) protocols are being used for Lyme disease serology testing in the clinic. We aimed to compare the real-world testing results of MTTT, a recently approved protocol, vs STTT, a mainstay protocol over the past decades. To this end, we obtained results of Lyme disease testing performed in a US national reference laboratory in 2022 and 2023 and constructed a matched cohort with 66,708 individuals tested using MTTT and 66,708 individuals tested using STTT. We found that, compared with STTT, MTTT identified more test positives in adults aged 18 and older and similar number of test positives in the children and adolescents. The odds ratio (95% confidence interval) of testing positive using MTTT vs STTT was 1.88 (1.79-1.98) in adults and 1.09 (0.97-1.23) in non-adults. In addition, more patients tested positive for immunoglobulin M antibody alone or positive for both immunoglobulin M and immunoglobulin G antibodies using MTTT than STTT.
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spelling doaj-art-c622b0eaae28440ca9ed6ec7fa41dfc72025-08-20T03:29:03ZengPublic Library of Science (PLoS)PLoS ONE1932-62032025-01-01206e032737610.1371/journal.pone.0327376Real-world Lyme disease testing results using modified vs standard two-tier test protocols.Yonghong LiZhen ChenCarmen H TongKy VanRobert S JonesLance A BareThe modified two-tier test (MTTT) and standard two-tier test (STTT) protocols are being used for Lyme disease serology testing in the clinic. We aimed to compare the real-world testing results of MTTT, a recently approved protocol, vs STTT, a mainstay protocol over the past decades. To this end, we obtained results of Lyme disease testing performed in a US national reference laboratory in 2022 and 2023 and constructed a matched cohort with 66,708 individuals tested using MTTT and 66,708 individuals tested using STTT. We found that, compared with STTT, MTTT identified more test positives in adults aged 18 and older and similar number of test positives in the children and adolescents. The odds ratio (95% confidence interval) of testing positive using MTTT vs STTT was 1.88 (1.79-1.98) in adults and 1.09 (0.97-1.23) in non-adults. In addition, more patients tested positive for immunoglobulin M antibody alone or positive for both immunoglobulin M and immunoglobulin G antibodies using MTTT than STTT.https://doi.org/10.1371/journal.pone.0327376
spellingShingle Yonghong Li
Zhen Chen
Carmen H Tong
Ky Van
Robert S Jones
Lance A Bare
Real-world Lyme disease testing results using modified vs standard two-tier test protocols.
PLoS ONE
title Real-world Lyme disease testing results using modified vs standard two-tier test protocols.
title_full Real-world Lyme disease testing results using modified vs standard two-tier test protocols.
title_fullStr Real-world Lyme disease testing results using modified vs standard two-tier test protocols.
title_full_unstemmed Real-world Lyme disease testing results using modified vs standard two-tier test protocols.
title_short Real-world Lyme disease testing results using modified vs standard two-tier test protocols.
title_sort real world lyme disease testing results using modified vs standard two tier test protocols
url https://doi.org/10.1371/journal.pone.0327376
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