摘要
目的了解玉林市5年来HIV抗体确证试验为不确定结果进行跟踪随访检测分析,为艾滋病精准防控提供科学依据。方法对2016~2020年玉林市辖区各医疗卫生单位送检的HIV筛查阳性血液样本,使用两种不同厂家抗体试剂进行复检试验,任意一种方法复检有反应的样本再用免疫印迹法(WB)进行抗体确证试验,HIV抗体WB不确定结果4周后跟踪随访再进行检测,同时使用HIV核酸定量检测作为补充实验。结果复检4798份样本,WB检测4263份,131例受检者为不确定结果,不确定率为3.07%;成功随访检测了76例(随访率为58.02%),失访55例(失访率为41.98%);阳转53例,阳转率为69.74%;带型gp160p24(43/131)以及gp160(37/131)出现频率位居前2位;主要带型中阳转率最高的是gp160gp120gp41为90.91%(10/11),其次是gp160p24为83.33%(25/30);随访了4例HIV抗体不确定孕产妇,阳转例数为0,均为阴性;HIV核酸定量(VL)检测>5000CPs/ml的患者WB试验阳转率为100.00%(53/53),VL<5000CPs/ml者最终排除了HIV感染;首次复检单反应结果随访阴转率为91.11%,阳转率为9.09%(2/22)(P>0.05)。结论双试剂快速法复检试验可减少不确定结果的产生;不确定人群失访率较高;出现HIV抗体不确定结果时采用HIV病毒核酸定量检测方法作为补充实验可更早确诊。
Objective To understand that HIV antibody confirmatory testing in Yulin city in the past 5 years has provided follow-up testing and analysis for uncertain results,so as to provide a scientific basis for the accurate prevention and control of AIDS.Methods The HIV screening positive blood samples sent by various medical and health units in Yulin district from 2016 to 2020 were retested with antibody reagents from 2 different manufacturers.The samples that responded to the retest with either method were subjected to antibody confirmatory test with western blot(WB).The HIV antibody WB was detected after 4 weeks of follow-up due to uncertainty in WB results,and quantitative HIV nucleic acid detection was used as a supplementary experiment.Results A total of 4798 samples were re-examined,and 4263 samples were tested for WB,and 131 subjects were found to be of uncertain results,with the uncertainty rate of 3.07%;76 cases(58.02%)were successfully followed up and 55 cases(41.98%)were lost to follow-up.The number of positive conversions was 53,and the positive conversion rate was 69.74%.The frequency of band patterns gp160 p24(43/131)and gp160(37/131)were in the top 2.The highest positive conversion rate in the main banding patterns was gp160 gp120 gp41,90.91%(10/11),followed by gp160 p24,83.33%(25/30).Four pregnant and parturients with HIV antibody uncertainty were followed up,and the number of positive cases turned to zero,all of which were negative.The positive conversion rate of WB test was 100.00%(53/53)in patients with HIV nucleic acid quantification(VL)test >5000 CPS/ml,and HIV infection was finally ruled out in patients with VL<5000 CPS/ml.According to the results of the first re-examination questionnaire,the negative conversion rate and the positive conversion rate in the follow-up were 91.11% and 9.09%(2/22),respectively(P>0.05).The follow-up management must be strengthened for the high loss ratio of follow-up.HIV viral load test leads to a more rapid diagnosis.Conclusion The double-reagent rapid re-examination t
作者
叶瑞国
庞贤武
庞晓泸
覃彦琳
宁珺茹
夏樱花
蒋宁
李劲锋
YE Rui-guo;PANG Xian-wu;PANG Xiao-lu;QIN Yan-ling;NING Jun-ru;XIA Ying-hua;JIANG Ning;LI Jing-feng(Yulin City Center for Disease Control and Prevention,Yulin,Guangxi,537000,China;不详)
出处
《预防医学论坛》
2021年第7期486-490,共5页
Preventive Medicine Tribune
基金
国家科技重大专项项目(项目编号:2018ZX10732101-002-007)
广西卫健委自筹课题(项目编号:Z20170134)
玉林市科学研究与技术开发计划项目(项目编号:玉市科201930002)。
关键词
复检试验
抗体不确定
随访
核酸检测
Reinspection
Antibody indeterminate
Follow-up
Nucleic acid testing
