HIV核酸检测在夫妻传播风险评价中的实例应用

Application of HIV nucleic acid test in risk assessment of transmission in a couple

目的明确1对艾滋病病毒（HIV）单阳夫妻中,妻子处于暴露风险后的感染状况,探讨HIV核酸检测技术的应用价值。方法对HIV阳性丈夫的首次确证阳性血清用Sedia公司和Maxim公司的限制性抗原亲和力酶免检测试剂盒进行新发感染检测,对阳性丈夫和其配偶F两次（距离暴露时间为12天和26天）采集抗凝全血,进行HIV抗体和HIV-1核酸检测。结果阳性丈夫检测为RECENT（新近感染）,第一次采集的血浆两种核酸定量检测方法结果分别为100拷贝/mL和160拷贝/mL,属于低病毒血症。配偶F两次采集的血浆核酸定量检测均为TND（核酸未检出）,其全血和淋巴细胞富积液样本的核酸（核糖核酸/脱氧核糖核酸）定性检测结果均为TND。暴露140天后配偶F检测为HIV抗体阴性且HIV-1p24抗原阴性。结论核酸检测技术能用于HIV暴露后的早期检测,预测HIV感染和传播风险。

Objective To clarify the infection status of a spouse in the risk of HIV exposure,and to explore the application value of HIV nucleic acid test（NAT）.Methods HIV-1 limiting antigen avidity（LAg-Avidity）enzyme immunoassay（EIA）kits produced by Sedia and Maxim were applied for detection of recent HIV-1 infection by using the serum of the husband.Anticoagulant whole blood samples were collected twice from the HIV-positive husband and his spouse F.Results The husband was detected as recent HIV-1 infection by HIV-1 LAg-Avidity EIA.The results of two NAT methods for the HIV-positive husband were 100 cps/ml and 160 cps/ml respectively for the first sampling,indicating the characteristic of low-level viremia.The plasma samples of suspected spouse F were collected twice and then detected as TND（target not detected）in the quantitative NAT detection,as well as the samples of whole blood and peripheral lymphocytes in the qualitative NAT（RNA/DNA）detection.At 140 days after exposure,spouse F was detected as negative both for HIV antibody and p24 antigen.Conclusion NAT can be used for early detection of HIV exposure,and predict the risk of HIV infection and transmission.