746例HIV初筛阳性者确证结果的对比分析

Comparative analysis on confirmatory testing results of 746 HIV screening positive cases

目的分析746例HIV初筛阳性标本的确证结果,探讨筛查阳性与确证结果之间的关系。方法对746例HIV初筛阳性标本的ELISA、GICA及WB检测结果进行比较分析。结果746例初筛阳性标本经ELISA、GICA复检后阳性标本714例,再经WB确证后674例为HIV-1抗体阳性,筛查阳性标本的确证阳性率为94.40%（674/714）。WB条带gp160出现率最高为99.41%,p55出现率最低为55.49%。确证阳性组和不确定组的S/CO值分别为（21.78±2.94）和（15.75±9.00）,两者差异无统计学意义（P〉0.05）。以WB试验结果为判定真阳性与真阴性的金标准,ELISA检测HIV抗体的敏感性为94.93%（674/710）,特异性为100.00%（36/36）;GICA检测HIV抗体的敏感性为97.68%（674/690）,特异性为89.29（50/56）,经χ^2检验ELISA与GICA检测结果差异有统计学意义（χ^2=348.60,P〈0.05）。ELISA阳性WB阴性的标本经核酸检测均为阴性。结论ELISA与GICA检测均为阳性的标本确证阳性率最高,高S/CO值提示感染HIV的可能性较大。

Objective To study the relationship between HIV screening positive and confirmatory testing results by analyzing the detection results of 746 samples. Methods The detection results by methods of ELISA,GICA and WB of746 HIV screening positive samples were compared. Results In 746 HIV screening positive samples,714 were positive after the detection of ELISA and GICA,then 674 were HIV-1 antibody positive after confirmatory test. HIV antibody confirmed positive rate was 94.40%（674/714）. The appearance rate of gp 160 was highest（99.41%）,and that of p55 was lowest（55.49%）. S/CO value of confirmed positive and unconfirmed samples were（21.78±2.94） and（15.75±9.00）respectively,and there was no significant difference between them（P 〉0.05）. Using WB as the gold standard to estimate the positive and negative results,the sensitiveness was 94.93%（674/710） and specificity was 100.00%（36/36） by ELISA while the sensitiveness was 97.68%（674/690） and the specificity was 89.29%（50/56） by GICA,and there was significant difference between the two methods compared by chi-square test（χ2=348.60,P 〈0.05）. Samples with ELISA positive but WB negative were all negative after nucleic acid detection. Conclusion The samples with both ELISA and GICA positive have the highest confirmed positive rate. High S/CO value（≥6.0） indicates the higher possibility of infection.