采用集合RNA检测方法估计高危人群的HIV感染发病率

Estimation on the HIV-1 incidence among high risk groups using the pooling RNA technique

目的及时发现艾滋病自愿咨询检测（VCT）人群和男男性行为人群（MsM）HIV抗体窗口期感染者，并估计发病率。方法收集2012年1—10月云南省疾病预防控制中心VCT门诊和MSM活动室H1V抗体筛查阴性样本，以50：1和10：1二级集合方式进行HIV-1RNA检测，并随访HIV-1RNA阳性者，最后以RonBrookmeyer方法估计VCT和MSM人群的HIV感染年发病率。结果1400份VCT门诊HIV抗体筛查阴性样本中，发现2名HIV-1RNA阳性窗口期感染者，HIV感染年发病率为1．87％（95％CI：1．23％～2．65％）。MSM500份HIV抗体筛查阴性样本中，发现2名HIV-1RNA阳性窗口期感染者，HIV感染年发病率为5_31％（95％CI：3．52％～7．45％）。结论集合RNA检测为及时发现VCT和MSM的HIV窗口期感染者提供有效方法，建议通过提高集合RNA检测频率等方式，加强MSM及其他高危人群HIV感染窗口期的筛查。

Objective To timely identify the HIV-1 infection in window-period and to estimate the HIV-1 incidence among people who came for voluntary counseling and testing （VCT） service as well as men who have sex with men（MSM） ,respectively. Methods HIV antibody negative samples that were determined by screening tests between January and October 2012, were collected and tested with pooling HIV-1 RNA testing technique （2-staged pooling by 50 ： 1,10 ： 1 ）. Positive cases were followed-up for HIV antibody testing while HIV incidence was calculated under Ron Brookmeyer＇ s method, among VCT and MSM populations. Results Among 1400 HIV antibody negative samples of VCT, two showed HIV-1 RNA positive during the antibody window period with the HIV-I incidence as 1.87% per year （95% CI： 1.25%-2.65% ）. Among 500 HIV antibody negative samples from MSM population, two showed HIV-1 RNA positive in the antibody window period, with HIV-1 incidence as 5.31% per year （95% Ch 3.52%-7.45% ）. Conclusion Pooling HIV-1 RNA testing seemed a powerful tool for HIV antibody testing in the window-period. Measures should be taken to strengthen the HIV diagnostic programs among MSM and other high risk groups, during the HIV antibody window-period. More frequent detection approach as pooling HIV-1 RNA testing might be a good choice.