类风湿因子IgM对化学发光法检测HIV抗体结果的影响

Effects of rheumatoid factor IgM on detection of HIV antibody by chemiluminescence assay

目的探讨类风湿关节炎(RA)患者血清类风湿因子(RF)免疫球蛋白M(IgM)含量对化学发光法(CLIA)检测人类免疫缺陷病毒(HIV)抗体结果的影响。方法选择2016年9月—2017年9月在黄石市中心医院确诊的120例RA患者作为RA组,再根据RF-IgM浓度分为3个亚组(包括RF-IgM<100 kU/L组、100～300 kU/L组和>300 kU/L组),另选择同期进行体检的120例健康体检者作为健康对照组。收集两组的血清,采用CLIA法分别检测两组的RF-IgM和HIV抗体,比较检测结果并进行统计学分析。结果HIV抗体初筛阳性率RA组为5%(6/120),健康对照组为0(0/120),两组比较差异有统计学意义(P<0.05)。RF-IgM<100 kU/L组的RA患者HIV抗体初筛阳性率为0(0/36),RF-IgM 100～300 kU/L组的RA患者HIV抗体初筛阳性率为4.88%(2/41),RF-IgM>300 kU/L组的RA患者HIV抗体初筛阳性率为9.30%(4/43),3组两两比较差异均有统计学意义(均P<0.05)。RA组6例HIV抗体初筛阳性者经上级医疗机构HIV确证实验室采用免疫印迹法确诊为HIV阴性。结论 RA患者RF-IgM含量与CLIA法检测HIV抗体阳性率成正相关,高浓度RF-IgM可能会干扰CLIA法对HIV抗体的检测。

Objective To investigate the effect of serum rheumatoid factor（RF） IgM in rheumatoid arthritis（RA） patients on the detection of human immunodeficiency virus（HIV） antibodies by chemiluminescence assay（CLIA）. Methods One hundred and twenty RA patients confirmed in the central hospital of Huangshi City from September 2016 to September 2017 were selected as the RA group, and according to the different concentrations of RF-IgM, they were subdivided into 3 subgroups, including RF-IgM 100 kU/L group（36 cases）, 100-300 kU/L group（42 cases） and 300 kU/L group（43 cases）, and 120 healthy subjects who had undergone physical examinations in the same period were selected as the healthy control group. The serum of the two groups was collected, RF-IgM and HIV antibodies of the two groups were respectively detected by CLIA method, and the detection results were statistically analyzed and compared between the two groups. Results The initial positive screening rate of HIV antibodies in RA group was 5%（6/120）, and that of HIV antibody in healthy control group was 0（0/120）, the difference in HIV antibody between the two groups being statistically significant（P〈0.05）. The percentages of number of patients with HIV antibody positive initially screened out in RF-IgM 〈100 kU/L group, 100-300 kU/L group and〉 300 kU/L group were 0（0/36）, 4.88%（2/41） and 9.30%（4/43） respectively, the comparison in difference between any pair of above 3 groups being statistically significant（all P〈0.05）. Six cases of HIV antibody positive screening in RA group were confirmed to be HIV negative by immunoblotting method in HIV diagnosis laboratory of higher medical institutions. Conclusion The RF-IgM content in RA patients is positively correlated with the positive rate of HIV antibody detected by CLIA method, and the high RF-IgM concentration may interfere with HIV antibody detection by CLIA method.