HIV抗体初筛阳性与免疫印迹试验结果对比性分析

Comparison of HIV positive results between ELISA screening and western blot test

目的 对浙江省普陀地区人类免疫缺陷病毒（HIV）抗体初筛试验阳性样本与免疫印迹试验（WB）进行对比分析,探讨筛查试验结果与WB结果的关联。方法 参照中国疾病预防控制中心《全国艾滋病检测技术规范》,对普陀地区185份HIV抗体初筛阳性标本采用WB进行确证,并对其结果对比分析。结果 经WB确认,HIV-1抗体阳性160份（86.49%）,HIV-1型抗体阴性13份（7.03%）,不确定性12份（6.49%）;酶联免疫吸附试验（ELISA）、胶体硒法与WB的阳性符合率分别为88.89%和89.89%,差异无统计学意义（P〉0.05）;WB确证HIV-1型抗体阳性、阴性及不确定标本的平均S/c.o值分别为（15.76±7.42）、（5.48±2.17）和（6.83±3.06）,差异有统计意义（P〈0.05）;11份标本的S/c.o值处于1~6,与确证试验阳性符合率为18.18%,17份标本的S/c.o值处于7~10,阳性符合率为70.59%,151份标本的S/c.o值〉10,阳性符合率为96.69%;确证试验为HIV-1阳性的样本中,gp^160、gp^120、gp^41、p^66、p^51、P^55、P^24条带出现的百分率均≥95%。结论 HIV抗体初筛试验存在一定的假阳性结果,HIV抗体结果必须以WB结果为准;WB确证试验有不确定结果,存在一定缺陷。

Objective To compare human iinmunodeficiency virus （HIV）positive results between enzyme linked immunosorbent assay（ ELISA）/Electro selenium screening and western blot（ WB ）test and to study the relationship between the results of screening and WB among the examinees in Putuo district of Zhoushan city, Zhejiang province. Methods Using methods described in the＂ National Guideline for Detection of HIV/acquired immunodeficiency syndrome （AIDS）＂ ,185 positive specimens ascertained by HIV antibody screening were confirmed by WB test. Results Of all the samples,160（86.49% ） were confirmed to be positive,13（7.03% ） samples negative and 12（6.49% ） samples uncertain by WB test. The positive coincidence rates of ELISA/Electro selenium method with WB were 88.89% and 89. 89% （ P 〉 0. 05 ）. The mean value of signal to cutoff （ S/c. o ） of WB confirmation test were 15.76 ± 7.42, 5.48±2. 17 and 6. 83 ± 3.06 for positive, negative and uncertain samples, respectively （P 〈 0. 05 ）. For the 11 samples with the S/c. o values of equal to or more than 1 and less than 6 ,the positive coincidence rate with WB was 18. 18% ;for 17 samples with the S/c. o value of equal to or more than 6 and less than 10 ,the positive coincidence rate was 70. 59% ; and for 151 samples with the S/c. o value of more than 10,the positive coincidence rate was 96. 69%. The appearance rates of gp^160 ,gp^l20 ,gp^41 ,p^66 ,p^51 ,p^55 ,p^24 reactive bands were all over 95% in WB confirmed HIV-1 antibody positive samples. Conclusion There are some false positive results in HIV screening test, suggesting the final HIV antibody test result must be confirmed by WB test,but WB test also has limitation for uncertain samples.