医院患者HIV抗体筛查阳性与免疫印迹试验结果对比分析

Comparative analysis of HIV antibody screening positive and western blot test results in hospital patients

目的对比分析HIV抗体筛查试验与免疫印迹试验结果,探讨抗体筛查阳性结果与确证结果之间的关系。方法参照《全国艾滋病检测技术规范》要求,对HIV抗体初筛阳性标本采用免疫印迹试验进行确证。结果 287份筛查阳性标本经WB确证后,251例为HIV-1型抗体阳性(87.46%),16例不确定(5.57%),20例阴性(6.97%)。ELISA、胶体硒法与WB试验的阳性符合率分别为89.96%和90.29%。WB试验阳性、不确定和阴性标本的EIISA平均S/CO值分别为16.93、6.996和5.568。S/CO值大于或等于1而小于6,与确证试验阳性符合率为18.75%;大于或等于6而小于10,阳性符合率为69.23%;S/CO值大于或等于10,阳性符合率为97.05%。确证为HIV-1型抗体阳性的标本,gp160、gp120、gp41、p66、p51、p24出现频率都在95%以上。结论筛查试验存在一定假阳性结果,随着S/CO值的增高,与确证试验的阳性符合率也升高,但是高S/CO值样品并不代表感染HIV,HIV抗体结果报告必须以WB结果为准。WB确证方法在不确定标本中存在一定缺陷。

Objective Comparing and analyzing the HIV antibody screening positive results and Western Blot test results,to study the relationship between screening positive results and Western Blot results.Methods According to the ＂National Guideline for Detection of HIV /AIDS＂,positive samples screened by HIV antibody screening test were confirmed by Western Blot test.Results Among 287 positive samples tested by primary screening test,251 samples were confirmed to be positive（87.46%）,16 samples indeterminate（5.57%）and 20 samples negative（6.97%） by WB test.The positive coincidence rates of ELISA/Electroselenium method and WB were 89.96% and 90.29% respectively.The mean value of S/CO were 16.93、6.996 and 5.568 in confirmatory positive group,indeterminate goup and negative group,respectively.When the S/CO value of the positive samples screened by ELISA equal to or more than 1 and less than 6,18.75% were confirmed by WB,and when equal to or more than 6 and less than 10,69.23% were confirmed by WB,and when more than 10,97.05% were confirmed by WB.The appearance rate of gp160、gp120、gp41、p66、p24 reactive bands were all over 95%in WB confirmed HIV-1 antibody positive samples.Conclusion With the S/CO values increased,the positive coincidence rate of ELISA and WB increased,but ELISA results with high S/CO values does not certainly mean HIV infection.The final HIV antibody test results must be confirmed by WB test as some false positives do exist in the screening test.WB test has limitation in indeterminate samples.