3类特殊HIV抗体WB带型病例转归情况研究

Study on the convert status of cases with three special WB belt types of HIV antibody

目的对3类特殊WB带型的病例转归情况进行分析研究,探讨HIV抗体确证试验在实际工作中存在的问题,为HIV抗体确证试验结果的判断和解释提供借鉴依据。方法对病例进行跟踪随访,结合初筛试验结果、WB条带特点、病毒载量结果、抗体转归情况及流行病学资料进行结合分析。结果 2例初检呈gp160、gp120带型的病例,1例随访仍为gp160、gp120,最终结合病毒载量和流行病学资料判为阳性,1例转为阴性;12例初检呈gp160、p24、p17或gp160、p24带型的病例,10例转阳,2例转阴;4例初检呈无特异性条带的病例,随访转阳。转阳的病例初检样本的病毒载量结果均为阳性,随访阴性的病例初检样本的病毒载量结果均为阴性。结论对于HIV抗体确证试验WB反应不强、刚满足判阳标准时,不能直接出具HIV-1抗体阳性报告,而对于第四代包含抗原检测试剂呈强阳性反应,即使确证试验为阴性,也必须进行随访。这3类样本应慎重对待,不能单纯依赖于HIV抗体检测,需结合病毒载量检测结果和流行病学资料辅助鉴别HIV感染状态。

Objective To analyze three special types of WB belt,and to discuss the problems in the actual work,so as to provide basis for the judgment and explanation of the result of HIV antibody confirmation test. Methods Following-up of cases was carried out,and preliminary screening results,WB band characteristics,viral load results,antibody convert status and epidemiological data were combined for analysis. Results One of the two cases with primary gp160,gp120 WB belt types,the follow-up result was the same,so it was diagnosed as HIV-1 positive in combination with positive viral load result and epidemiological data; the other one case converted to be negative. 12 cases with primary gp160,p24,p17 or gp160,p24 WB belt types,10 cases converted to be positive,while 2 cases converted to be negative. 4 cases showing no specific band primary converted to be positive after follow-up. Cases with positive viral load of the initial samples were confirmed to be positive,while cases with negative viral load were proved to be negative after follow-up. Conclusion When the WB reaction was not significant and just beyond the positive standard in the HIV antibody confirmation test,these cases couldn＇ t be directly diagnosed as HIV-1 positive. When the ELISA S/CO of the reagent containing antigen detection was high,these cases must be followed-up. The three kinds of samples should be treated with caution,which couldn＇t simply rely on HIV antibody test,so viral load test results and epidemiological data should be combined to identify HIV infection status.