酶联荧光分析法在HIV感染筛查中的应用

Application of enzyme-linked fluorescent assay used for screening of HIV infection

目的分析酶联荧光分析法(ELFA)检测艾滋病病毒(HIV)阳性反应样本与蛋白印迹试验(WB)确证结果的相关性,探讨ELFA在HIV感染筛查中的应用。方法回顾2014年6月至2016年3月,杭州市各筛查实验室上送样本中,ELFA检测HIV抗体阳性反应样本2 113例,HIVp24抗原阳性反应样本39例,用WB试验进行确证。比较ELFA阳性反应结果和WB确证结果的相关性,分析ELFA检测HIV抗体不同检测值对WB确证结果的预测性。结果 2 113例抗体阳性反应样本与WB试验结果符合率为98.25%(2 076例)。剔除46例无随访结果的样本,进一步讨论2 067例抗体阳性反应样本,ELFA法检测HIV抗体阳性预测值为97.92%(2 024例)。39例HIVp24抗原阳性反应样本首次WB确证36例(92.31%)为结果不确定,已随访的23例均确证为阳性。结论ELFA检测HIV抗体抗原结果直观,抗体阳性反应样本和WB确证试验有很好的相关性和预测性,是HIV抗体检测S/CO比值替代策略中一种较好的检测方法。

Objective To analyze the correlation between the HIV positive samples screened by enzyme-linked fluorescent assay （ELFA） and confirmed by western blot （WB）, and to investigate the possible application of ELFA in HIV infection screening. Methods A retrospective study was made for all the cases of HIV positive by screening laboratories of Hangzhou from June 2014 to March 2016, with 2113 HIV antibody-positive and 39 HIVp24 antigen- positive samples detected by ELFA, and WB was used for confirmation. The results between ELFA positive and WB confirmation were compared, and the different ELFA detection values of HIV antibody against WB confirmatory results were analyzed. Results The coincidence rate was 98.25% （2076/2113） between 2113 antibody-positive samples screening and WB test results. In the follow-up of 2067 HIV antibody-positive samples, the predictive HIV antibody-positive value detected by ELFA was 97.92% （2024/2067）. 39 HIVp24 antigen-positive samples were tested by WB for conformation with 92.31% （36/39） indeterminate at the first test, and among them 23 cases fol- lowed-up were all confirmed positive by WB later. Conclusion Detection for HIV antibody by ELFA has direct re- sults and good correlation between antibody values and those by WB confirmation test, with high HIV antibody de- tection values （〉10.00） and good predictability for HIV antibody-positive results confirmed by WB. Therefore, S/ CO ratio substitution strategy is a good approach for HIV antibody detection.