Phage Test for Active Tick-borne Infections

Rationale for Phage Tests in Borrelia and Rickettsia

Red Laboratories is offering a test called the Phelix Phage Test. A phage test is designed to detect the genetic material of viruses called bacteriophages that are present when a specific bacteria infection is present. So, there is a specific bacteriophage for each type of Borrelia and for each type of Rickettsia. If a bacteriophage virus is present that means the bacteria it is meant to attack is also present. Thus, a positive Borrelia phage test means a person is still infected with Borrelia. And a positive Rickettsia phage test means a person has Rickettsia living in them. In theory the quantity of phages should correspond with the germ load of Borrelia or Bartonella.

Red Labs has phage testing for the following infections:

• Phelix Phage Borrelia Test for Borrelia and Tick-Borne Relapsing Fever. The test is able to detect a broad range of Borrelias from all 3 groups, i.e. (i) Borrelia miyamotoi, (ii) Borrelia burgdorferi sensu lato species (B. burgdorferi s.s., B. bissetti, B. bavariensis, B. valaisiana, B. afzelii, B. garinii), (iii) Borrelia Relapsing fever species (B. hermsii, B. recurrentis, B. crocidurae, B. duttonii, etc)
• Phelix Phage Rickettsia Test. The test is able to detect a broad range of Rickettsias: Rickettsia japonica; Rickettsia heilongjiangensis; Rickettsia parkeri; Rickettsia raoultii; Rickettsia rickettsia; Rickettsia slovaca; Rickettsia montanensis; Rickettsia peacocki; Rickettsia africae; Rickettsia conorii.

Ready for Prime Time—Maybe Yes, Maybe Not

In my opinion the Phelix Phage Test is still being validated. The company that developed the test has only performed one published validation experiment. Here is the link to that study. This study showed that when a test is positive, an infection is present. However, it did not establish how good the test is at finding the infections in people infected, also called sensitivity.

My take on the test is that when the Phelix Phage Test is positive, it does mean the infection is present (this point still needs further validation studies). However, there are no studies done to detect how sensitive this test is at detecting infection when it is present. So a negative test does not necessarily prove Borrelia, Tick-borne Relapsing Fever, or Rickettsia are not present.

By comparison, IGenex Immunoblots are about 90% or more sensitive, meaning they will find the infection when it is there 90% of the time. See my review of IGenex Immunoblots in The Best Lab & Test for Borrelia, Bartonella, & Babesia. For a review of the range of testing methods for Borrelia see A Review of Lyme Infection Tests: Pass or Fail.

Possible Role for Phelix Phage Test

If further validation studies show this test is effective and accurate, it may be useful to detect if there is a significant germ load of Borrelia or Rickettsia.

• Presence of Infection After Antibiotics. In other words it could be used to detect if there is active infection, even after long periods of herbal or prescription antibiotics.
• Long Covid vs Lyme Reactivation. In theory it could also test for reactivation of Lyme. This could be helpful in someone who remains ill after Covid to determine if they have Long Covid or reactivation of a Borrelia infection keeping them ill.

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