2010-2015年唐山市HIV抗体蛋白印迹试验检测结果分析

Analysis of HIV antibody Western blotting results in Tangshan city from 2010 to 2015

目的对唐山市2010-2015年艾滋病病毒(HIV)抗体初筛阳性标本的确证实验结果进行回顾统计分析,为唐山市的艾滋病检测工作提供技术支持。方法对来自唐山市辖区内63家HIV初筛实验室酶联免疫吸附试验筛查结果为双阳或一阴一阳的1085例标本,使用蛋白印迹试验进行确证实验。用SPSS-19进行统计分析。结果1085例样本中,确证阳性707例,阳性率为65.2%;不确定176例,不确定率为16.2%;阴性202例,阴性率为18.6%;2010-2015年各年确证阳性率、确证不确定率和确证阴性率间差异有统计学意义(χ2=97.694,P<0.001)。2010-2015年确证阳性率分别为62.1%、50.6%、44.5%、63.9%、81.7%、77.7%。自愿咨询检测的确证阳性率(92.4%)高于医疗机构(70.8%)(χ2=51.994,P<0.001)。医疗机构确证阳性率高于血站(28.4%)(χ2=177.346,P<0.001)。确证阳性结果中全带型占54.3%;不确定结果随访率为31.3%,其中出现p24、gp160带型的样本随访阳转率为100%。结论 2010-2015年确证阳性率有提高;出现全带型的确证阳性病例已经不是新近感染;提示加强宣传,增加自愿咨询检测量,加强医疗机构的检测范围,以期发现更多的早期感染病例,同时加强不确定结果的随访力度,尽早发现感染者,避免二代传播。

Objective To analyze the results of HIV antibody screening positives by Western blotting（WB）for confirmation,and provide technical support for Tangshan HIV/AIDS prevention and control.Methods 1085 samples with two times of screening results as HIV positive or one positive and one negative were collected from 63 HIV ELISA screening laboratories in Tangshan,and got WB for the confirmation.Results Of 1085 samples,65.2%（707/1085））was confirmed as HIV positive,16.2%（176/1085）indeterminate,and 18.6%（202/1085）negative.The confirmed positive rate were 62.1%,50.6%,44.5%,50.6%,81.7%,and 77.7%respectively from 2010to2015,Each of the confirmatory positive rate,confirmation of uncertain confirmed rate and negative rate with the difference statistically significant（χ^2=97.694,P〈0.001）.The confirmed positive rate of the HIV screened samples from voluntary counseling and testing（VCT）clinics was 92.4%,higher than those from the medical institutions（70.8%χ^2= 51.994,P 〈0.001）,and blood stations（28.4%,χ^2= 177.346,P〈0.001））.The confirmed positive results showed 54.3% with all belt types.Among the indeterminate results of the confirmatory tests by WB,the follow-up rate was 31.3% and the samples with p24,gp160 belt types had 100% converted to HIV positive during the follow-up period.Conclusion The confirmed positive rate is increasing from 2010 to 2015and those（54.3%）with all belt types is not newly HIV infected cases,suggesting that we should upgrade the awareness of AIDS related knowledge,and promote early detection by VCT clinics and medical institutions,in order to avoid the secondary HIV transmission.