辽宁省2007—2011年HIV抗体不确定结果分析

Analysis of indeterminate HIV antibody western blot profiles from 2007-2011 in Liaoning province

目的分析艾滋病病毒(HIV)抗体不确定结果的特点、产生的原因及其对检测工作的影响。方法对2007—2011年辽宁省艾滋病确证中心实验室检出的302例HIV抗体不确定患者的带型及61例完成随访检测患者的确诊结果进行分析。结果 302例HIV抗体不确定者有18种带型,不确定构成比排在前3位的带型是:p24占43.4%(131/302),gp160 p24占19.2%(58/302),gp160占18.9%(57/302);HIV主要有3个结构抗原:外膜蛋白(env)类的带型有12种,样本例数构成比为51.0%(154/302),核心蛋白(gag)类的带型有2种,样本例数构成比为46.7%(141/302),多聚酶(pol)类的带型有4种,样本例数构成比为2.3%(7/302);61例HIV抗体不确定患者完成随访检测,其中16例确诊为阳性,占26.2%;16例阳转者env类条带占93.8%(15/16),61例随访检测人员env类条带占59.0%(36/61),差异有统计学意义(χ2=12.103,P<0.01);22例gag类条带不确定患者经随访检测未发现阳性。结论针对gag蛋白的不确定反应最为常见,但基本上都是非特异反应;env类不确定结果预示HIV感染的意义较大。

Objective To study the serological characterization of indeterminate western blot results of human immunoldeficiency virus（HIV）antibody and to find the causes and the influence of the indeterminacy. Methods The data for 302 cases with indeterminate HIV antibody western blot profiles and 61 patients receiving follow-up diagnostic testing in Liaoning AIDS Corroboration Center Laboratory from 2007-2011 were analyzed. Results There were 18 strip types in the 302 cases with indeterminate HIV antibody western blot profiles,with the top three types of p24（43.4%,131/302）,gp160 p24（19.2%,58/302）,and gp160（18.9%,57/302）.HIV showed three main structure antigens,with 12 strip types of env（51.0%,154/302）,2 strip types of gag （46.7%,141/302）,and 4strip types of pol（2.3%,7/302）.Among the 61 cases completing the follow-up detection,16（26.2%）were diagnosed as positive.In the 16 positive patients,strip type of env was dominant（93.8%,15/16）.For the 61 cases,the proportion of env type was 59.0%（36/61）,with significant difference（＆chi;2=12.103,P〈0.05）.There were 22 indeterminate strip type of gag showed negative result at the end of follow-up. Conclusion The results indicates that the most common indeterminate HIV western blot profile is gag protein strip for unspecific reaction and the profile of env has more predictive significance for HIV infection.