两种HIV筛查试剂的比较及首次CD4+T淋巴细胞检测结果分析

Comparison of two HIV screening reagents and analysis of first CDT lymphocyte test results

目的比较两种人类免疫缺陷病毒(HIV)筛查试剂在南宁市无偿献血人群中的筛查效果,并进行首次CD4+T淋巴细胞检测,为制定合理的血液筛查提供参考依据。方法采用两种酶联免疫吸附试验(ELISA)对2017—2019年南宁中心血站送检的HIV筛查有反应的标本进行复检。其中一种使用进口的第4代抗原抗体联合检测试剂,另一种采用国产的第3代抗体检测试剂。当一种和/或另一种试剂有反应时,则用免疫蛋白印迹试验(WB)进行进一步确证,并对部分送检的抗凝全血标本进行CD4+T淋巴细胞计数。结果共收集到398份送检标本,复检有反应标本共356份,其中对进口第4代试剂和国产第3代试剂有反应的样本分别为309和129份,两种试剂均有反应的样本共122份。WB结果表明,两种试剂复检均有反应且样本吸光度值/临界值(S/CO)>5的HIV-1抗体阳性样本为68份(占19.10%),HIV抗体不确定样本为13份(占3.65%),HIV抗体阴性样本为275份(占77.25%)。CD4+T淋巴细胞计数检测结果显示,WB结果为阳性、不确定和阴性标本CD4+T淋巴细胞均值分别为(309.46±135.69)、(405.42±203.17)和(710.14±263.84)个/μL。结论HIV第四代抗原抗体试剂比第三代抗体诊断试剂敏感,但特异性比第三代试剂差,CD4+T淋巴细胞计数检测可以作为HIV感染的辅助诊断。

Objective To compare the effects of two screening reagents for human immunodeficiency virus(HIV)in non-paid blood donors in Nanning City,take the first CD4+T lymphocyte test,and provide reference data for the formulation of reasonable blood screening.Methods Two enzyme-linked immunosorbent assays(ELISA)were used to re-examine the HIV screening specimens sent from Nanning Central Blood Station from 2017-2019.One used imported fourth-generation antigen-antibody combined detection reagents,and the other used domestic third-generation antibody detection reagents.When one and/or the other reacted,further confirmation was performed by western blot experiment(WB),and CD4+T lymphocyte counts were performed on some anticoagulated whole blood samples submitted.Results A total of 398 specimens were collected for examination,of all,356 specimens were reexamined.Among them,309 and 129 samples reacted to the imported fourth-generation reagent and domestic third-generation reagent respectively,and a total of 122 samples responded to both reagents.WB results showed that 68 samples(19.10%)were positive for HIV-1 antibody with absorbance value/critical value(S/CO)>5 when both reagents were retested and reacted,13 samples(3.65%)were uncertain for HIV antibody,and there were 275 HIV-1 antibody negative samples(77.25%).CD4+T lymphocyte counts test results showed that the mean values of CD4+T lymphocyte in positive,uncertain and negative samples for WB test were(309.46±135.69),(405.42±203.17)and(710.14±263.84)cells/L,respectively.Conclusion The HIV fourth-generation antigen-antibody reagent is more sensitive than the third-generation antibody diagnostic reagent,but show lower specificity.CD4+T lymphocyte counts detection can be used as an auxiliary diagnosis of HIV infection.