广州市808例HIV抗体筛查阳性孕产妇复核和确证结果分析

Re-inspection and confirmation for 808 HIV antibody preliminary screening positive pregnant women,Guangzhou

目的了解孕产妇HIV抗体检测结果特点、内在规律以及假阳性情况,为科学实施艾滋病母婴干预策略提供参考。方法回顾分析2004—2013年广州市HIV抗体筛查阳性孕产妇样本的酶联免疫吸附法(ELISA)复核和免疫印迹法(WB)确证检测结果。结果 808份HIV抗体筛查阳性样本中复检阳性538份,复检试验阳性符合率为66.58%(538/808)。538份复检阳性样本经WB确证检测,320份为HIV-1抗体阳性,确证试验阳性符合率为59.48%(320/538);62份为确证检测不确定样本,不确定率为11.52%(62/538)。62份不确定样本中追踪45份,3份阳转,阳转率为6.67%(3/45)。S/CO值<4的样本,WB试验均未检出阳性,当S/CO值≥4时样本开始检出阳性,阳性率随着S/CO值升高而升高。结论孕产妇HIV抗体检测假阳性率较高,应根据实验结果并结合流行病学史等相关资料作出HIV感染判断,科学实施母婴干预工作,同时应积极采取措施规避假阳性结果。

Objective To understand the characteristics,inherent law and false-positive rate of HIV-antibody detection in pregnant women so as to provide reference for intervention strategies of mother-tochild transmission of HIV. Methods Retrospective analysis of re-inspection and confirmation was conducted for pregnant women who were HIV-antibody preliminary screening positive in Guangzhou City during2004 to 2013. Results Amongst 808 samples for re-inspection,the coincidence rate of preliminary screening and re-inspection was 66. 58%（ 538 /808）, the coincidence rate of confirmation test was59. 48%（ 320 /538）,and the uncertain rate was 11. 52%（ 62 /538）. Of 62 uncertain samples,45 were followed up and 3 of them were HIV-seroconversion with a conversion rate of 6. 67%（ 3 /45）. The samples with S / CO 4 were all confirmed negative. When the S / CO value was equal to or higher than 4,the samples turned to be positive. The positive rate increased with the increase of S / CO value. Conclusion The false positive rate was high in HIV antibody detection in pregnant women and the diagnoses of HIV infection should be considered with experiment results and epidemiological history information in maternal intervention.