breakdown of Igenix test bands:

MEANING OF IGENEX TEST:

The following is a breakdown of the Western blot only. As co-infections will show their own titers. IgM is a sign of a current infection. IgG can be a sign of a current infection if symptomatic, or of a past exposure to or past infection by the organism.

~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~`

PLEASE BE AWARE MANY LLMD'S CONSIDER A BAND THAT IS 'IND' AS POSITIVE, IGENEX TEST READS 'IND's' ARE SIGNIFICANT AND DOES NOT INDICATE A NEGATIVE.

IGeneX also now offers a new 30-31kDa Confirmation IgG and IgM test. If results from the initial Western Blot are positive for bands 30 or 31, it is possible that these could be due to cross-reactivity with several different types of viruses. In this confirmatory test, highly specific recombinant antigens are used to validate that the positive result is not due to cross-reaction with viruses.

There are nine known Borrelia burgdorferi genus specie specific KDA Western Blot antibodies (bands): 18 23 30 31 34 37 39 83 and 93.

Only one of these Borrelia burgdorferi genus specie specific bands is needed to confirm that there is serological evidence of exposure to the Borrelia burgdorferi spirochete and can confirm a clinical diagnosis of Lyme disease. (More info pages 12 & 13 "Western Blot Made Easy": http://www.publichealthalert.org/PHA%20JUNE%2007.pdf )

Igenex Western Blot Break Down by band

9 cross-reactive for Borrellia

12 specific for Bb

18 highly specific to Lyme (Many LLMD's say if this band alone is positive, you have lyme - see link above)

20 cross-reactive for Borrellia

21 unknown

22 specific for Bb, probably really the 23/25 band

23-25 outer surface protein C (OspC), specific for Bb

28 unknown

30 unknown; probably an outer surface protein; common in European and

one California strain - Has cross-reactivity with several different types of viruses

31 outer surface protein A (OspA), specific for Bb - Has cross-reactivity with several different types of viruses

34 outer surface protein B (Osp; specific for Bb

35 specific for Bb

37 specific for Bb

38 cross-reactive for Bb

39 is a major protein of Bb flagellin; specific for Bb

41 flagellin protein of all spirochetes; this is usually the first to appear after a spirochete infection but is NOT specific to Lyme (i.e, other spirochete diseases have flagellas - see link above "Western Blot Made Easy" for more info)

45 cross-reactive for all Borellia

50 cross-reactive for all Borrellia

55 cross-reactive for all Borrellia

57 cross-reactive for all Borrellia

58 unknown but may be a heat-shock Bb protein

60 cross reactive for all Borrellia

66 cross-reactive for all Borrelia, common in all bacteria

83 specific antigen for the Lyme bacterium, probably a cytoplasmic membrane

93 unknown, probably the same protein in band 83, just migrates differently in some patients[/b]

An IgM positive test result means more recent & likely currently active infection. IgG positive means previous exposure to the bacteria or older infection of Lyme. If no symptoms are present with IgG positive, it may mean an "inactive" LD infection. No matter the results, please remember LD is a clinical diagnosis, you can have a negative test and still have Lyme Disease and the co-infections, even through the best labs. If you have symptoms, you need treatment.

also, some good info:

Co-infections

Organism Prevalence

Babesia 8-20% *

Bartonella 40-70%

Ehrlichia 10-50%

Borrelia 18-40%

Mycoplasma 25-70%

* Some Lyme doctors have

estimated that the presence of

Babesia infection may actually be

70% or higher based on their clinical

experience.

When reviewing the symptoms

caused by the various coinfections,

it becomes clear that

there is significant overlap

between the symptoms which

result from co-infections and those

that are caused by Borrelia itself.

Though Borrelia may be the ringleader,

it is critical that one not

overlook the very real and almost

certain reality that co-infections

may be a significant part of one's

current condition.

In summary:

• Co-infections are the RULE, not

an exception.

• The average child with Lyme disease

has 2-5 co-infections with an

average of 3.

• Treatment of co-infections is

required and often, they must be

treated before or concurrent with

the Borrelia treatment itself.

• If you don't test for and treat coinfections,

you are not putting

yourself in a good position for

healing.

• Most people with chronic Lyme

have 1 or more co-infections.

• Co-infections require different

treatments in many cases. Do not

assume that you are covering them

with only the Lyme treatment.

• Co-infection testing is often

unreliable as well and you need to

repeat them over time.

(taken from www.truthaboutlymedisease.com thank you Dana for such wonderful info)

Thanks Jaime!! May I add that you can also have any or many of the coinfections WITHOUT Lyme!

And those ranges of coinfection prevalence dont really mean anything. You need geographic specificity. If the original author can go back to the citation there may be a breakdown of say "northeast" "middle states" etc.Coinfections vary as much if not more than the Lyme Borrelia do!

When many pass along generalized data its very hard to extrapolate the meaning.

Especially statements like "most people" etc.

Also Im a bit confused over the bands explanation. It says that Band 12 is Bb specific but its NOT listed in the first list. The same as for 22, 35 bands. And the note of cross reactivity of 45,50,55,57,60,66 WHAT is it cross reactive with??

So I went to the source (something I always do and tell others to do as well) and at IGENEX they have a wonderful article explaining this! Some of it is not the same as Dana's information.I dont believe anyone uses a single band as diagnostic--certainly even Igenex requires 2 of their starred bands!!( using 2 of Igenex starred bands gives >96% specifics, using only one would give LESS)

http://igenex.com/Website/#

QUOTE:

The IgG Western Blot is an immunoassay and qualitative test in which antibodies are visualized. The IgG antibody is typically present a few months following initial infection. It is a qualitative test and is generally more sensitive and specific than the ELISA. This test must be used if the Lyme IgG/IgM antibody serology or Lyme IgG/IgA/IgM IFA is equivocal or positive.

The somewhat specific Lyme antibodies of importance are against the following molecular weights of the B. burgdorferi antigens:

23-25 kDa (Osp C); 31 kDa (Osp A); 34 kDa (Osp ; 39 kDa; 41 kDa (common of flagella-bearing organisms); and 83-93 kDa. The term “kDa” refers to kilodalton for molecular weight designations. The term “Osp” refers to Outer Surface Protein of the bacteria.

There are currently multiple criteria that support a positive blot. “Positive” means consistent with the presence of antibody against B. burgdorferi. The CDC/ASTPHLD criteria are very conservative and require 5 of 10 bands for a positive result; equivocal or borderline results are not recognized.

Unfortunately, not all Lyme patients have similar immune systems: only approximately 70% of those with Lyme disease generate a strong enough antibody response to appear on a western blot. IGeneX criteria of 2 starred bands is >96% specific for exposure to B. burgdorferi.

The CDC/ASTPHLD criteria for positive results are 5 of the following 10 antigenic bands: 18 kDa, 23-25 kDa (Osp C); 28 kDa, 30 kDa, 39 kDa; 41 kDa, 45 kDa, 58 Kda, 66 KDa, and/or 83-93 kDa.

IGeneX criteria for positive result is 2 of the following 6 bands: 23-25kDa, 31 kDa (Osp A), the 34 kDa (Osp , 39 kDa, 41kDa and/or the 83-93 kDa. 31kDa and 34kDa antigens are included to the criteria due to their importance in the recurrent and/or persistent disease period. IGeneX criteria of is 96% specific for exposure to B. burgdorferi.

A positive IgG result with clinical history may be indicative of Lyme disease. Patients with other spirochetal disease and/or who test positive for rheumatoid factor or Epstein Barr virus may have cross-reacting antibodies. A positive response in this, as in any antibody assay, indicates sensitization, not necessarily active disease

IGM

The IgM Western Blot is a very sensitive indicator of exposure to B. burgdorferi. It may be positive as early as 1 week after a tick bite. This test will usually remain positive for six to eight weeks after initial exposure. Re-exposure will also cause this test to be positive for a brief period of time. For the testing to be complete, it is preferable that the IgM blot be run along with the IgG blot.

The antibody specificities of importance for the IgM blot are the same as those for the IgG blot. The CDC/ASTPHLD criteria for positive results are 2 of the following 3 antigenic bands: 23-25 kDa (Osp C); 39 kDa; and/or 41 kDa.

IGeneX adds the 31 kDa (Osp A), the 34 kDa (Osp (with the argument that these two antigens were used for the vaccines and therefore, antibodies to these antigens are of importance) and/or the 83-93 kDa to the criteria due to their importance in the recurrent and/or persistent disease period.

IGeneX criteria of 2 bands is 96% specific for exposure to B. burgdorferi. Sera from patients with some acute viral infections can give false positive results. Therefore, an IgM viral panel may useful to rule out false positives IgM Western blot results due to viral infection. Note: The IgM Western blot is often positive in patients with persistent infection. Sometimes it is the only marker detected.

A positive IgM result with clinical history may be indicative of early Lyme disease or persistent infection in otherwise serologically negative individuals. Recently reported data support our observation that some Lyme patients may have only restricted IgM response to B. burgdorferi.

END QUOTE

I apologize if Ive stepped on toes but I cant ignore my training as both a scientist and educator to cite the source and therefore the best factual information!

be well

Finette

If I misinterpreted and this was a compilation of many sources about Band interpretation in general,I apologize.

I myself wasnt commenting on whether any test or lab was better--I only was talking about igenex' meaning again due to my assumptions of the topic.

btw band 41 ia very NON lyme specific and thats what makes the clinical dx so important as you mentioned.

I have a question--why does it look like my post has smiley's that I didnt put there?? what did I do wrong while typing it??

Finette

Id take your child to a LLMD and have a complete panel done--including the many co-infections that are endemic to your area.And keep a simple sx diary--changes of sx and patterns can help with dx.

The tests are marginally helpful and its a clinical dx--meaning that a very experienced professional has to look at sx and physical exam and other factors which then culminates into a dx

Band 41 is very non specific and that why the Jemsek Clinic printed the following:

[As was stated above, the three IgM bands selected for qualifying a Bb infection are 23, 39, and 41. It is widely recognized that band 41 is present in the general population at a high incidence and therefore is a common false positive.

One then wonders why band 41 is included at all in this small group of antigens that qualify a Bb infection. On the other hand, both bands 23 and 39 are considered highly specific for Bb infection, yet we require at least 2 bands for a diagnosis.

Since we feel that the specificity of either the 23 or 39 band is quite high for Bb infection, and therefore the false positive rate exceedingly low when one of these bands are present, we believe that the detection of only one of these antigens is highly probable for laboratory confirmation of active LD.

In this way, we differ in a major way from the stated criteria of the currently establishing committee. ] end quote

a great explanation of bands from MDL labs--another excellent lab as good as Igenex is here

http://www.mdlab.com/pdf/interp_guide_lyme_12_05.pdf

"just" 41 may not mean anything BUT again if there are sx and possible exposure--again a reason to seek another opinion from a LLMD

good luck

Finette

18++, 30+, 31IND, 39+, 41++++, 66+ and mine said CDC positive and igenex positive.

Julie

I was tested serially by MDL and Igenex over the years and only after 4 or 5 years did I ever have anything positive and only for a short time--it never parallels sx for me

and I had 1 unusual rash during pregnancy and then 2 bullseye rashes--the first at the same year 4 or 5 as the positive tests then recently ( last spring- year 17--about 3 or 4 yrs out of remission-- tested neg) and there was NO way for a re-infection/re-exposure

so even that as a dx criteria is faulty--depends on how your immune system is, if the spirochetes are migrating etc

frustrating that its not as easy as a Strep dx!!!