Antibody tests have limitations and there are other “cellular” tests looking at a different part of the immune system. T cell tests for example are known to be helpful in some diseases, such as TB, but so far, their use in LB has not been proved. There is a study in progress in the Netherlands to try to work this out.
van de Schoor FR et al. Validation of cellular tests for Lyme borreliosis (VICTORY) study. BMC Infect Dis. 2019;19(1):1-9.