献血者HIV RNA窗口期标本的追踪和随访

Tracking and follow-up study of an HIV RNA window period blood donor

目的对处于HIV RNA窗口期的献血者做追踪、随访和验证。方法分别使用第3、4代酶联免疫试验(ELISA)方法(试剂)、免疫印迹试验(WB),以及核酸检测技术(NAT)定性和定量等方法,对在血液筛查中检出的1例献血者HIV窗口期不同时间(根据献血者的配合度间隔4-8 d)的血液标本做追踪和随访检测。采用ELISA方法以双试剂检测抗-HIV;同时采用全自动NAT单检分析系统,对该例血液标本做了HBV、HCV、HIV 3项NAT联检和鉴别试验。结果该例献血者标本首次检测:ELISA抗-HIV非反应性,NAT定性试验反应性;随后NAT定量试验和抗-HIV确认试验(WB)也同为阴性。采用双试剂ELISA和WB确认方法对献血者追踪、随访检测4次,至3周后确认为血清学抗-HIV转阳,获得到了1个完整的血清学转化结果。结论首次追踪、随访检测得以确认1例重庆地区病毒载量较高的HIV RNA窗口期献血者;NAT检测有利于阻截该HIV RNA窗口期献血者的血液流向临床。

Objective To track,follow-up and verify a HIV RNA window period blood donor.Methods The donor blood sampleswere collected at different stagesduringthe window period（every 4-8days depending on thedonor status）.Tracking,detection and follow-up study were performed usingthe 3rd and the 4th generation enzyme Linked immunosorbentassay（ELISA） reagents,qualitative and quantitative nucleic acid tests（NAT）.Routine serological testswith two ELISA reagents was performed while NATsingle assay were conducted for HBV,HCV and HIVtests.Results The first ELISAtestresultwasnon-reactivewhilethe qualitative NAT was reactive.The quantitative NAT and West Blot（WB） results were,however,both non-reacitve.We tracked andtested thedonor＇s blood samples 4 timestill the serologicalresults turnedreactive after three weeks.Thus acquiringa complete processofserological conversion.Conclusion It was the first time to track、follow-up,test and confirm ahighvirusload donorin an HIV RNA window period in Chongqing area.NAT technology is capable of blockingsuchinfectedblood sourcefrom clinicaluse.