HIV-1抗体不确定者跟踪监测结果分析

Analysis of the tracking and monitoring results in patients with uncertain HIV-1 antibody

目的分析产生HIV抗体不确定结果的原因,为完善检测策略提供依据。方法统计分析34例HIV-1抗体不确定者WB试验的条带特征。对其中的20名不确定者继续跟踪随访,采集血样,进行抗体确证试验和病毒载量检测。结果 537例HIV-1抗体复筛阳性的血样进行了确证试验,不确定者34例,不确定比为6.33%;不确定者带型主要集中在p24(38.24%)、gp160(29.41%)、gp160p24(11.76%)、p24p17(11.76%)。对孕产妇、婴幼儿、学生、检测咨询这4种人群特征不确定率进行统计学分析,孕产妇和学生的不确定率较高,具有统计学意义(Ρ<0.001);对20例不确定者跟踪随访检测,有5例转为阳性结果,15例转为阴性结果。结论根据《全国艾滋病检测技术规范》,慎重处理HIV抗体不确定结果。根据WB确证条带,及时进行HIV病毒核酸的检测,并结合流行病学资料和临床症状,可以缩短不确定者的随访检测时间。

Objective To analyze the causes of HIV antibody with indeterminate results and provide the basis for improving detection strategy. Methods Analyze stripe features of 34 cases of HIV- 1 antibody uncertainty by WB. Following up 20 uncertain and collecting blood samples,do western blotting test and viral load test. Results There were 537 samples treated with confirmatory test,among which 34 samples were indeterminate with the uncertainty proportion of 6. 33%. Belt types were mainly concentrated in p24（ 38. 24%）,gp160（ 29. 41%）,gp160p24（ 11. 76%）,p24p17（ 11. 76%）. Uncertain rates of the maternal and the students were higher with statistical significance（ P〈 0. 001）; 20 uncertain were followed up,among which 5 cases turned to be positive,and 15 cases to negative. Conclusion According to the National AIDS Testing Technical Specifications,we have to carefully handle the HIV antibody indeterminate results. According to the bands of uncertain,timely detecting HIV nucleic acids and combining with epidemiological data and clinical symptoms,we can shorten the detection time of uncertainty that are followed.