HIV唾液快检在口腔科门诊的现场应用及检测结果分析

Field application of oral rapid HIV testing in Department of Stomatology and analysis of test results

目的了解口腔科门诊就诊者HIV唾液快检接受度,HIV阳性检出率情况,分析检测结果。方法为口腔科门诊就诊者提供免费的HIV唾液快检及问卷调查,计算其接受率,了解拒绝HIV唾液快检的原因,对阳性检测结果采血复查。结果在816名就诊者中,有784名就诊者接受PITC服务并完成了HIV唾液快检,检测率为96.08%;拒绝HIV唾液快检主要原因最近1个月内才检测过HIV、认为对他们提供HIV检测是对其一种冒犯、认为自己绝对不可能感染HIV;接受了HIV唾液快检的就诊者中,阳性检出率为0.38%,假阳性率为0.51%;其中3例确证阳性者所患口腔疾病分别为口腔黏膜白斑、口腔念珠菌感染、牙髓炎;仅有的2例患有口腔癌的患者其HIV唾液快检结果均为假阳性,而患者身体情况、生活习惯对HIV唾液快检假阳性的影响较小。结论 HIV唾液快检由于其安全可靠、可以及时获取检测结果的特性使其在口腔科有很好的接受度,极大的推进了HIV检测,且口腔科HIV阳性检出率较高,口腔科医生需对出现艾滋病的口腔首发症状者加以重视,口腔癌容易导致假阳性的出现。

Objective To investigate the acceptability, HIV positive rate and false positive of oral rapid HIV testing in department of stomatology, and to analyze the results of detection. Methods The free oral rapid HIV testing was offered and a questionnaire survey was performed to patients of department of stomatology, calculate their acceptance rate, understand the reasons for refusing PITC, and review the positive test results with blood test. Results Among 816 outpatients, 784 accepted the doctor＇s PITC service and tested for HIV（96.08%）. Outpatients refused the doctor＇s PITC service for the following primary reason： had tested in last month; considered to the test was offensive to him; for no risk. Among 784 outpatients, the HIV positive rate and false positive rate of oral rapid HIV testing was 0.38% and 0.51% respectively. Of the 3 positive patients, 1 had oral leukoplakia, 1 had pulpitis and 1 had oral candidiasis, of the 4 false positive patients, 2 had oral cancer, while physical condition and life style had little influence to false positive. Conclusion The oral rapid HIV testing has a good acceptance in stomatology because of its safety, reliability and timely access to test results. It greatly promotes the detection of HIV. The positive rate of HIV in stomatology is high. Stomatologists should pay attention to the first symptoms of AIDS in oral cavity. Oral cancer is easy to lead to false positive results.