2011-2014年威海市HIV抗体筛查阳性标本的确证结果分析

Analysis on the Confirmatory Testing Results of HIV Screening Positive Cases in Weihai City,2011-2014

目的对威海市2011-2014年艾滋病病毒(HIV)抗体筛查阳性标本的确证试验结果进行分析,为威海艾滋病防治工作提供技术支持。方法 2011-2014年威海市辖区内25家筛查实验室,采用第四代酶联免疫吸附试验(ELISA)及胶体硒试验,对送检的及本筛查中心实验室检出的220例筛查阳性标本,使用蛋白印迹试验(WB)进行确证试验。结果 220例筛查阳性标本中,确证HIV-1抗体阳性185例,阳性率为84.09%;确证阴性11例,阴性率为5.00%;HIV抗体不确定24例,占10.90%。筛查阳性标本来源于医疗、疾病预防控制中心、采供血机构,其中采供血机构的阳性率为63.64%(14/22)。确证的185例中,条带gp160和gp120出现率为100%,p55、p39条带的阳性率分别为62.70%(116例)、61.08%(113例)。在随访到的不确定标本中,条带含有gp160、p24的带型转阳率很高。二次确证有13.92%(11/79)的标本和一次确证的带型不一致。结论 HIV抗体初筛试验结果存在一定的假阳性,HIV抗体结果以WB结果为准;WB试验中不确定标本需做好随访工作,尽量减少潜在新发感染者的流失。一次、二次确证不一致的标本可作为研究新发感染的依据之一。

Objective To analyze the detection results of 220 HIV confirmatory tests in Weihai city during 2011-2014,so as to provide technical support to the HIV/AIDS prevention and control.Methods 220 cases of HIV positive samples screened from 2011 to 2014by the fourth generation of enzyme-linked immunosorbent assay（ELISA）（colloid selenium test）were collected from the 25 screening laboratories in the city and got confirmation for HIV detection by Western Blot tests.Results Of the 220 screening positive samples,HIV-1antibody confirmed positive rate was 84.09%（185/220）;the negative rate was 5%（11/220）;and the uncertain rate was 10.90%（24/220）.The positive rate of blood center was the lowest[63.64%（14/22）]compared with those from medical clinics,and CDC.Of the confirmed 185 cases,occurrence rate of stripe gp160gp120 was 100%;positive rate of p55,p39 bands was 62.70%（116cases）,and 61.08%（n=113）respectively.In the follow-up to the uncertain samples,the seroconversion rate with strip containing gp160,p24 was very high.13.92%（11/79）samples had different strip types in the two confirmatory tests.Conclusions There are some false positive results in the HIV antibody screening tests,and the results of HIV antibody to WB results shall prevail;the sample of HIV antibody uncertain should be followed up to minimize the loss of potential recent infections.The samples of strip types different in the first and second confirmatory tests can be used as the basis to know the recent HIV infections.