[Infection by Borrelia burgdorferi in patients with the human immunodeficiency virus. A diagnostic problem]

Given that Lyme's disease and HIV infection may present with similar clinical symptoms and that the serologic tests for the determination of antibodies against Borrelia burgdorferi present frequent false positives, the presence of antibodies against B. burgdorferi in patients with HIV in different evolutive stages was studied.

Antibodies against B. burgdorferi were determined by IFI and ELISA in a serum sample of 72 individuals with HIV. Western blot (WB) against B. burgdorferi was performed in the sera which were positive by one method or the other. The presence of antiphospholipid antibodies was also studied.

A total of 24 sera (33%) were positive by IFI and/or ELISA. Twenty-one (29%) by IFI and 7 (10%) by ELISA (chi 2; p = 0.006). Four (5.5%) were positive by both methods. Only one of the sera was positive by IFI, ELISA and WB. No statistical relation was found upon comparison of the positive results against B. burgdorferi with the different evolutive stages of HIV infection or with the presence of antiphospholipid antibodies.

The high prevalence of false positive serology to B. burgdorferi in the collective of patients with the human immunodeficiency virus infection together with the possibility of presenting similar clinical manifestations has led to extreme prudence in the diagnosis of infection by B. burgdorferi in patients with HIV infection.