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On the usefulness of serology testing in infectious diseases: selected topics.

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Serology testing allows the determination of immunity against different infecting organisms via the dosage of IgG. When the direct detection of a pathogen is not possible, detection of specific IgM antibodies or antigens may also help to diagnose an acute infection. This article describes the usefulness of serological testing for the diagnosis or the follow-up of some infectious pathologies:
Lyme disease, sexually transmitted diseases (STD) and Epstein-Barr virus (EBV). Serological diagnosis of
Lyme disease is difficult. Results must always be interpreted in correlation with clinical symptoms: on the one hand, the presence of antibodies could be correlated either with a recent or a past infection; and on the other hand, sensitivity of
Lyme serology is low in the early stages. Concerning STD, the direct detection of the pathogen must be preferred for Herpes simplex, Chlamydia, mycoplasma and gonorrhoea infections. For detection of HIV, HCV, HBV and syphilis, serological testing is the method of choice. The diagnosis of infectious mononucleosis is based on the detection of specific EBV IgM antibodies and should be preferred to the detection of heterophilic antibodies such as Paul and Bunnel test. EBV reactivation are very rare in immunocompetent patients, but can occur in immunocompromised, particularly transplanted patients and can lead to a lymphoproliferative disorder. Surveillance of these patients can be followed with the monitoring of EBV viral load. Serological testing in this case is generally not useful.

Rev Med Brux. 2011 Sep;32(4):285-8. English Abstract

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