2015-2017年自贡市78例HIV抗体检测不确定结果者追踪分析

Tracing Analysis of 78 Cases With Uncertain HIV Antibody Test Results in Zigong From 2015 to 2017

目的 追踪分析艾滋病病毒（HIV）抗体确证试验免疫印记试验（WB）确证不确定结果,预测HIV抗体不确定者抗体进展情况。方法 自贡市疾病预防控制中心HIV确证实验室2015-2017年确证试验（WB）不确定结果共追踪检测到78例不确定病例,把这78例不确定样本的血清学结果、带型以及临床资料进行综合分析,结合HIV-1病毒载量检测结果进行综合判断。结果 78例WB确证不确定样本共有6种带型,有2种带型出现比例相对较高,P24出现27例（27/78）,占34. 6%,gp160＋p24出现25例（25/78）,占32. 1%。在基因组env类中,阳性转归比例最高（41/51）,占80. 4%。78例HIV抗体不确定样本随访阳性51例,阳转率为65. 4%,阴性27例,阴转率为34. 6%。结论 在本次追踪检测到的不确定者结果当中,不同人群在复检时阳转情况不同。从带型上分析,env类提示感染HIV的作用最大,窗口期缩短和有些患者的非特异性反应都可能导致不确定结果的出现。HIV抗体检测出现不确定结果时用病毒载量检测做有效补充,有利于对HIV感染状态进行准确判断。

Objective To track and analyze the confirmed inconclusive results of human immunodeficiency virus （HIV） antibody with Western Blot （WB） test, and to predict the progression of the antibody among those HIV antibody uncertain cases. Methods From 2015 to 2017, there were 78 uncertainty cases detected and tracked by HIV confirmation laboratory of Zigong city center for disease control and prevention. These 78 cases were analyzed on serology results, banding pattern and clinical data, as well as their HIV - l viral load test to make a comprehensive judgement. Results Among the 78 WB verified uncertain patients, there were a total of 6 patterns of banding, of which two kinds of banding showed relatively high proportion, p24 cases accounted for 34. 7% of the total （27/78）, followed by gp160 ＋ p24, which accounted for 32. 1% of the total （25/78）. The patients of positive conversion were mainly from the group of genomic env category, accounted for 80. 4% of the total （41/51 ）. Among the 78 HIV antibody uncertainty samples, the positive seroconversion rate of the patients was 65.4% （51/78） , the negative seroconversion rate was 34.6% （ 27/78 ）. Conclusion According to the testing results of these HIV antibody uncertain eases, different groups of people showed different positive conversion during the reexamination. By analysing the banding pattern, the genomic env category was the most effective way to indicate the HIV infection, the shortening of window period and the non-specific reactions in some patients may lead to the occurrence of uncertain results. The detection of HIV antibody uncertainty may be effectively supplemented by the viral load test, which can help to accurately determine the status of HIV infection.