Heightened lymphocyte responses to B. burgdorferi are found in patients with Lyme disease but elevated responses also frequently occur in healthy controls. At present, the interpretation of a positive lymphocyte response to B. burgdorferi would be difficult in ambiguous clinical situations.

Human lymphocytes proliferate in vitro in response to foreign histocompatibility antigens that are present on allogeneic lymphocytes. Within a population of immunocompetent lymphocytes there are specific subpopulations that respond to allogeneic cells from different individuals. A means of selectively eliminating such subpopulations is suggested.

For most patients with a positive Lyme antibody titer whose only symptoms are nonspecific myalgia or fatigue the risks and costs of empirical parenteral antibiotic therapy exceed the benefits. Only when the value of patient anxiety about leaving a positive test untreated exceeds the cost of such therapy is the empirical treatment cost-effective.

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