HIV-1 WB试验不确定样本的HIV-1 RNA定量检测结果分析

Analysis of HIV-1 RNA quantitative testing results of HIV-1 antibody indeterminate samples by WB test

目的探讨1型艾滋病病毒(HIV-1)核糖核酸(RNA)定量检测,在HIV-1抗体不确定样本诊断中的应用,为类似样本的诊断提供参考。方法对31例HIV-1抗体不确定的样本进行HIV-1RNA定量检测,通过随访并结合流行病学资料确定其感染状况。结果 31例HIV-1蛋白印迹试验(WB)不确定样本中,HIV-1RNA定量检测结果高于检测限的18例,低于检测限的13例。HIV-1RNA定量检测结果高于检测限的18例中,随访15例,占83.3%;其中11例抗体阳转,4例WB带型无进展,但复查HIV-1RNA定量检测结果仍高于检测限,判定为HIV感染。HIV-1RNA定量检测结果低于检出限的13例中,随访4例,占30.8%;其中2例WB带型消失(p24),2例带型无进展(p24 1例,p24、gp160 1例),其中1例(p24和gp160)复查,HIV-1RNA定量检测结果仍低于检测限,结合流行病学资料排除HIV感染。结论 HIV-1RNA定量检测是WB试验的有效补充,在HIV-1抗体不确定时,尽快采用HIV-1RNA定量检测并结合流行病学资料分析,有助于更快对个体HIV感染状态进行诊断。

Objective To study the application of HIV-1 RNA quantitative testing in diagnosis of HIV-1 antibody in- determinate samples and provide reference for the similar samples diagnosis. Methods 31 samples of HIV-1 anti- body indeterminate results were tested by HIV-1 RNA quantitative testing, and the infection status were determined by the follow-up testing in combination of the epidemiological data analysis. Results Out of 31 samples of HIV-1 antibody indeterminate by WB test, 18 samples with HIV-1 RNA quantitative testing results were above the detec- tion limit and 13 samples were below. Among the 15 cases （83.3%） of the 18 samples followed up, 11 samples were determined as HIV positive and another 4 samples had no progress in WB bands development, which showed that the HIV-1 RNA quantitative testing results were still above the detection limit after rechecking and determined as HIV infection. Among the 4 samples （30.8%） followed up out of the 13 samples with HIV 1 RNA quantitative testing results below the detection limit, 2 samples were negative and another 2 samples had no progress in WB bands development （p24, p24 and gpl60）, which had HIV-1 RNA quantitative testing results below the detection limit after rechecking. So the latter two were determined as non-HIV infection with analysis of the epidemiological data. Conclusion HIV-1 RNA quantitative testing is effectively supplementary to WB test and it is useful for diag- nosis of HIV infection, when WB result is HIV-1 antibody indeterminate.