摘要
目的探讨免疫印迹法(Western blots, WB)检测HIV抗体不确定带型的转归及其与疾病分期的规律,为HIV感染的实验室诊断提供线索。方法回顾性分析2015年9月至2017年12月首都医科大学附属北京佑安医院艾滋病确证实验室131例首次HIV抗体WB检测结果为不确定的病例的临床资料,分析不同带型的临床转归,及其与初筛S/CO值、CD4^+ T细胞计数以及临床分期之间的关系。结果 WB不确定带型共10种,按条带个数分为1条带、2条带和3条带3种类型,其HIV阳转率差异有统计学意义(χ~2=30.31,P=0.00);WB不确定病按例临床转归结果分为阳性和阴性,两者初筛S/CO值分别为30.70±28.39和2.82±5.74(F=25.81,P=0.00),CD4^+ T细胞计数分别为(328.83±250.63)个/μl和(569.92±143.06)个/μl,差异均有统计学意义(F=4.75,P=0.03);将阳转病例分为急性期组和艾滋病期组,急性期组的不确定带型为p17、p24、gp160、p51p66、p24gp160、p17p24gp160,艾滋病期组带型为gp120gp160和gp41gp120gp160,两组初筛S/CO值和CD4^+ T细胞计数差异均有统计学意义(P <0.05),两组HIV-1 RNA定量差异无统计学意义(P> 0.05)。结论 WB不确定带型随条带数增加,阳转率增高,结合初筛S/CO比值和CD4^+ T细胞计数,根据WB不确定带型可判断其临床转归和分期。
Objective To analyze the characteristics of the HIV antibody indeterminate bands tested by Western blots(WB) and provide clues for rapid and accurate laboratory diagnosis of HIV infection. Methods One hundred and thirty-one cases of AIDS Confirmation Laboratory of Beijing Youan Hospital from September 2015 to December 2017 with first uncertain WB test results of HIV antibody were analyzed retrospectively. Chi-square test was used to analyze the relationship between the clinical outcome of the HIV antibody indeterminate bands, the initial screening S/CO value, CD4^+ T cell counts and clinical stage. Results There were 10 types of the HIV antibody indeterminate bands. The bands were divided into three types by one belt, two belts and three belts according to the number of bands, and the positive conversion rate was statistically significant(χ~2= 30.31, P = 0.00). Cases were divided into positive and negative according to clinical outcome. The preliminary screening S/CO ratios were 30.70±28.39 and 2.82±5.74(F = 25.81, P = 0.00) respectively, and CD4^+ T cell counts were(328.83±250.63)/μl and(569.92±143.06)/μl(F = 4.75, P = 0.03), respectively. The p17, p24, gp160, p51 p66, p24 gp160,p17 p24 gp160 were acute stage bands, and gp120 gp160 and gp41 gp120 gp160 were AIDS stage bands. The difference of S/CO ratios and CD4^+ T cell counts between the two groups was statistically significant(P < 0.05), and the difference of HIV RNA quantitation was no statistically significant(P > 0.05). Conclusions The positive conversion rate increases with increasing of the belts of WB indeterminate bands. Combined with the HIV preliminary S/CO ratio and CD4^+ T cell counts, the clinical outcome and clinical stage may be determined based on different WB indeterminate bands.
作者
冯霞
娄金丽
刘翠娥
刘意
马红丽
李健维
Feng Xia;Lou Jinli;Liu Cuie;Liu Yi;MaHongli;Li Jianwei.(Department of Clinical Laboratory, Beijing Youan Hospital, Capital Medical University, Beijing 10069, China)
出处
《北京医学》
CAS
2019年第6期448-450,454,共4页
Beijing Medical Journal
