摘要
目的探讨联合应用HIV核酸定量检测(病毒载量,viralload,VL)与HIV抗体确证试验(Western-blotting,WB)优化艾滋病“一站式”诊断流程,建立有效可行的补充试验检测方案。方法2014年3—9月,收集广西6个现场点县医院常规HIV-1抗体筛查试验有反应的样本,同时进行VL和WB检测,比较不同补充试验检测方案的诊断效果与检测成本。结果6个现场点共有185例新发现HIV抗体筛查试验有反应,以男性为主(占74.6%),年龄中位数为52岁。在WB方法中,HIV-1抗体阳性有174例,占94.1%;在VL方法中,VL>5000拷贝/mL有181例,占97.8%。在174例HIV-1抗体阳性的样本中,VL为20、20~5000、5001~100000及>100000拷贝/mL分别有2例(1.1%)、2例(1.1%)、51例(27.6%)及130例(70.3%)。10例HIV-1抗体不确定的样本,其VL均为100000拷贝/mL。WB、VL、WB/VL和WB+VL四种补充试验方案可明确诊断HIV感染的比例分别为94.1%、97.8%、99.5%和99.5%,其检测成本分别为112750、146050、116380和17300元。结论艾滋病“一站式”诊断流程以WB/VL检测方案为最优,即WB检测结果为HIV-1抗体不确定或阴性的样本再做VL检测,该方案可以提高HIV感染诊断的准确性和减少检测成本。
Objective To explore the combination of nucleic acid quantitative detection (viral load,VL)and Western-blotting(WB)to optimize the“one-stop”HIV diagnostic detection and establish an effective and feasi-ble supplementary testing scheme.Methods From March 2014 to September 2014,the samples that were reac-tive to the routine HIV -1 antibody screening test were collected at six sites of county -level hospitals in Guangxi,China.These plasma samples were tested by WB and VL.The diagnostic results and testing costs were compared between the different complementary testing schemes.Results There were 185 cases reactive to HIV-1 antibody screening test in the six sites,which were male-dominated,accounting for 74.6%,and the me-dian age was 52.The results of WB showed 174 cases were positive to HIV-1,which accounted for 94.1%.In the results of VL test,181 cases were VL >5 000 copies/ml,which accounted for 97.8%.Among the 174 cases of WB positive,the viral load levels of <20, 20-5 000,5 001-100 000,and >100 000 copies/ml were 2 cases(1.1%),2 cases(1.1%),51 cases(27.6%),and 130 cases(70.3%),respectively.The viral load level of all 10 case with the indeterminate HIV antibody in WB test were >100 000 copies/ml.The rates of definite diagnosis for HIV infection in the detection scheme with WB,VL,WB/VL,and WB +VL were 94.1%,97.8%, 99.5% and 99.5%,respectively.The cost of detection were 112 750 yuan,146 050 yuan,116 380 yuan and 173 800 yuan,respectively.Conclusions WB/VL is the optimal detection scheme of supplementary test in the"one - stop"HIV diagnostic detection,that is,the indeterminate or negative HIV antibody samples by WB are tested by nucleic acid quantitative detection,which can improve the accuracy and reduce the cost of HIV detection.
作者
方宁烨
唐凯玲
庞贤武
王露
何芹
梁淑家
周崇兴
沈智勇
蓝光华
唐振柱
李剑军
FANG Ning-ye;TANG Kai-ling;PANG Xian-wu;WANG Lu;HE Qin;LIANG Shu-jia;ZHOU Chong-xin;SHEN Zhi-yong;LAN Guang-hua;TANG Zhen-zhu;LI Jian-jun(Guangxi Zhuang Autonomous Region Center for Disease Prevention and Control,Nanning,Guangxi 530028,China)
出处
《应用预防医学》
2019年第3期186-189,共4页
Applied Preventive Medicine
基金
国家自然科学基金项目(81360442,81460510)
广西科学研究与技术开发项目(桂科攻1298003-1-4)
