用HIV抗原/抗体联合试剂筛查吸毒者中窗口期HIV感染者

Screening of HIV carriers in window period among IDUs by using the fourth generation HIV test kit

目的筛查窗口期艾滋病病毒(HIV)感染者,并验证HIV抗原/抗体联合试剂(第四代试剂)的检测性能。方法用HIV抗原/抗体联合试剂对经HIV抗体筛查呈阴性反应的吸毒者样本进行检测,并与HIV抗原检测及HIV-1 RNA检测的结果作比较,以证实其为窗口期感染样本。结果1 934份HIV抗体阴性样本中发现3例窗口期HIV感染者;所用第四代试剂检出窗口期样本的敏感性为100%,特异性为99.28%,假阳性率为0.77%。结论用第四代试剂检测虽然可以在某种程度上缩短检测窗口期,但该试剂有一定的假阳性结果,尤其是在S/CO值较低时其假阳性比率增高,故检测时应注意S/CO值的高低,如有条件可进一步做HIV-1 RNA检测。

Objective By using the fourth generation test kit （HIV antigen/antibody agent）to screen IDUs serum specimens and to evaluate its effectiveness for detecting early HIV infection in window period. Methods All the specimens were tested by the third generation test kit initially,and the negative specimens were tested by the fourth generation test kit. The specimens which were positive by the fourth generation test kit were compared with p24 antigen and HIV-1 viral load test kit respectively to confirm the window period HIV infection. Results Window period infection was confirmed in 3 specimens out of 1 934 HIV antibody negative specimens by the fourth generation test kit. The sensitivity of the forth generation test kit in detecting window period HIV infection was 100 %, specificity99.2 % and false-positive rate was 0.77 %. Conclusion Although the fourth generation test kit is effective in detecting the window period HIV infection,it shows relatively high false positive rate, therefore it is important to look at the S/CO values（the lower S/CO values the higher false positive reaction rates） ,and HIV-1-RNA test may be necessary if feasible.