菏泽市蛋白印迹试验HIV-1抗体不确定结果分析

Analysis of indeterminate results of HIV-1 antibody by western blot test in Heze

目的分析蛋白印迹试验（WB）检测艾滋病病毒（HIV）抗体＂不确定＂结果的特征、带型特点、随访转归情况,以了解WB检测HIV抗体可能存在的问题,为HIV抗体＂不确定＂结果的随访和诊断提供参考。方法将菏泽市HIV-1抗体＂不确定＂者的检测结果、条带、社会学特征、随访及抗体转归情况录入数据库,进行整理分析。结果 21例＂不确定＂者中,自愿咨询检测（VCT）门诊检测者占47.62%（10例）,义务献血者占28.57%（6例）,住院病人占23.81%（5例）。男性占90.48%（19例）,女性占9.52%（2例）。年龄分布在17-68岁之间。21例中随访到13例,10例转为HIV抗体阳性,阳转率76.92%;3例转为阴性,占23.08%;失访7例,失访率33.33%;死亡1例。HIV抗体检测结果＂不确定＂的样本出现8种带型,分别为gp160、gp120、p24、p66、p51、p31、p17、p41,其中gp160、gp120出现频次最高。表现为12种带型组合。出现gp160/gp120带型的不确定者后期随访全部转为阳性。结论同时出现gp160和gp120两条Env带的不确定者预示有较大感染风险,对此＂不确定＂者的随访周期可缩短至1或2周。

Objective To describe the features,bands characteristics and follow-up tests of indeterminate human immunodeficiency virus（HIV）antibody by western blot test（WB）,and to find out the problem of WB detection of HIV antibodies so as to provide the basis for the follow-up and diagnosis of indeterminate HIV-1antibodies.Methods WB indeterminate results were collected from 2003 to 2015in Heze city and then followed by the analysis of features of HIV antibody,stripes,and follow-up review database.Results There were 21 cases of uncertain results among 525 screened HIV positives during 2003-2015,with 47.62%（10/21）from VCT clinic detection,28.57%（6/21）from voluntary blood donors,and 23.81%（5/21）from hospital patients.Among them,men accounted for90.48%（19/21）,and women for 9.52%（2/21）.Age distribution was between 17-68 years old.10 cases out of 21 were diagnosed as HIV positive and 3cases as negative after follow-up tests,7were lost to follow-up,and 1was dead.The HIV antibody test results appeared uncertain specimens of 8belt types,i.e.gp160,gp120,p24,p66,p51,p31,p17,and p41.Gp160 and gp120had the highest frequency.There were 12 kinds of banding patterns.All the subjects of gp160gp120 bands followed up were confirmed as HIV infection.Conclusion Env indetermination is greatly predictive of HIV infection,especially the belts which contain gp160 and gp120.We suggest that the time of the follow-up period should be shortened from one month to 1or 2weeks for the re-testing.