腔镜检查前HIV感染筛查结果分析

Analysis of HIV infection screening before ednoscope examination

目的了解腔镜检查前患者人类免疫缺陷病毒抗体1型与2型（抗-HIV1/2）阳性率及其流行病学特征。方法在23 182例腔镜检查前患者中,筛选人类免疫缺陷病毒（HIV）感染与艾滋病（AIDS）患者。用抗-HIV1/2快速胶体硒初筛,可疑者再用抗-HIV1/2酶联免疫法证实;两者均阳性者,按初筛阳性报送确认实验室进行HIV感染确认试验;对抗-HIV1/2阳性患者的年龄、性别、传播途径、就诊科室和首发病症等进行分析。结果23 182例腔镜检查前患者,检出抗-HIV1/2阳性35例,阳性率为0.15%,其中男、女性比例为3∶2;年龄以20-49岁为主。其中HIV/HBsAg双阳者5例,占14.3%;HIV/HCV双阳者6例,占17.1%;HIV/HBsAg/HCV均阳性者1例,占2.9%。35例HIV感染者中,经血液传播占74.3%;职业为农民者占57.2%。就诊时症状缺乏特异性,多以消化道及肺部真菌感染等接受胃镜、肠镜和气管镜等检查,其中肠镜和气管镜检查各占总例数的34.2%和31.4%。结论腔镜检查前进行抗-HIV检测,有助于及时发现HIV感染者,避免腔镜检查传播HIV而引起医源性交叉感染。

Objective To understand the positive rate and epidemiologic character of human immunodeficiency virus antibody type - 1 and type - 2（anti - HIV1/2） in patients before endoscope check. Methods To screen the human immunodeficiency virus （HIV） infection and acquired immune deficiency syndrome（AIDS） patients in 23182 examinees before endoscope check. The anti - HIV1/2 colloidal selenium quick test was adopted first and then the anti - HIV1/2 enzyme imrnunoassays was used in the suspects. The doubtful positive results were sent to affirming laboratory for HIV infection ascertainment. The age, sex, infection route, diagnosis section and initial disorder of anti - HIV1/2 positive patients were analysed. Results There were 35 cases of anti - HIV1/2 positive patients with the positive rate of 0.15 % in the subjects. The male/ female ratio was 3：2 for the positive at ages of 20- 40. Among the HIV/HBsAg double positive subjects, the rate of HIV/ HCV double positive, HIV/HBsA_g/HCV positive was 14.3 % （ 5 cases）, 17.1% （ 6 cases） and 2.9 % （1case）, respectively. 74.3% of the 35 HIV infections was via blood transmission and 57.2 % was farmers. The most of the subjects accepted the gastroscop, eintestine scope（34.2 % ） and bronchosc0pe（31.4 % ） examination because of digestive tract or lung epiphyte infection. Conclusion The anti - HIV examination is helpful to find HIV infections in time. And it could avoid to spread the HIV in endoscope check.