我国现行HIV检测策略和方法的应用评价

Evaluation of Current strategies and methods used in HIV testing

目的 评价我国现行HIV检测方法和程序的应用效果。方法 按照我国《全国艾滋病检测工作规范》规定的方法和程序,分3个步骤对7502份职业献血员的血清标本进行了HIV抗体检测,用一种国产试剂进行初筛,阳性标本用原有试剂和另外种不同原理的试剂进行复核,两种试剂均阳性和一阴一阳的标本用免疫印迹试剂进行确认。结果 初筛能够发现所有的HIV阳性,排除98.8％HIV阴性,但是有0.9％假阳性;复核实验能够在确认之前排除93.9％假阳性。确认实验最终确认19份标本HIV抗体阳性,4份标本HIV抗体可疑。90.9％假阳性和75.0％可疑标本的s/CO值在1.000-1.999之间,而94.7％阳性标本的s/CO值在5.000以上。结论 复核实验对于有效排除假阳性,提高确认的效率,减少开支很有必要。s/CO值≥5.000预示阳性的价值比较大,s/CO值在1.000-1.999范围内多为假阳性或可疑。

Objective To assess current methods and strategies used in HIV testing in our country. Methods According to the procedure provided by the National Working Standard for AIDS Tests, HIV antibodies in 7 502 serum samples from paid blood donors were tested. Three steps were included. First, screening was done by using one domestic HIV antibody ELISA kit;Second, the reactive samples were retested with the same kit and another kit in different principle;Third, the reactive samples, which are positive in both tests or positive in one test and negative in the other test in the second step, were confirmed with Western Blot. Results Eighty nine specimens were reactive and 7 413 samples were recognized as negative in the first step. The false positive rate was 0.88% . Most of false positive specimens(93.9% )were excluded in the second step. Eventually, 19 positive samples and 4 suspicious samples were confirmed. Conclusion Retest is very necessary for eliminating false positive reaction before confirm action and for cost saving. The value of s/CO is useful for judging the true or false positive reactions. When the s/CO is larger than 5.000, it is most possible that the reaction is positive.