Modified Two-Tiered Testing Enzyme Immunoassay Algorithm for Serologic Diagnosis of Lyme Disease, 2022, Khan et al

Abstract
The modified 2-tier testing algorithm (MTTT) for Lyme disease (LD) has been approved by the US Food and Drug Administration. In this study, we show that the MTTT detected 28% more cases of early infection compared with the standard 2-tier algorithm while retaining high specificity in a region with a high incidence of LD.

Open access, https://academic.oup.com/ofid/article/9/7/ofac272/6603340

 

So, this is a big deal, this MTTT. Go to the CDC Lyme website and there are now TWO accepted methods to test positive for Lyme: The conventional 2-tier with an ELISA and Western Blot, and this "new" MTTT.

The modified two-tiered test -MTTT - with two first tier or ELISA tests - counts just so long as one of those two first tier tests is VlsE1-pepC10.

This new first tier is kinda sorta related to the C6, but only half of it. The other half is based on an OspC protein I think, which concerns me. On paper it would seem to make it more appealing to early stage Lyme candidates, but what about late stage??

I have tested positive with the MTTT twice in the last year; nevertheless I am leery of it.