HIV抗体初筛阳性报告检测策略探讨

Discussion on the detection strategy of HIV antibody "positive" report in primary screening

目的探讨人类免疫缺陷病毒(human immunodeficiency virus,HIV)抗体检测中酶联免疫加快速试验替代策略的可行性。方法采用酶联免疫吸附法(enzyme linked immunosorbent assay,ELISA)对我院2015年门诊及住院患者进行HIV初筛检测。ELISA筛查有反应(阳性)样本再用2种快速试剂复核,同时用免疫印迹法(westernblotting,WB)进行确证,不确定样本及时随访或进一步做核酸检测。结果533例HIV初筛有反应(阳性)样本,WB确证495例阳性,阳性符合率92.9%,7例不确定样本核酸检测阳性;与WB法相比较,当ELISAS/CO>6.67时,阳性预测值为99.2%。结论ELISA法随着S/CO值的升高阳性符合率也随着升高。ELISA法S/CO>6.67、2种快速试验均为阳性时,可以替代98.57%的WB确证检测,且与WB法或核酸的符合率为100%。在保证检测质量的前提下,可以减少检测费用,缩短检测时间。

Objective To evaluate the feasibility of an alternative strategy of enzyme-linked immunosorbent assay (ELISA) accelerated test in human immunodeficiency virus (HIV) antibody detection. Methods ELISA was used to detect HIV among outpatients and inpatients in our hospital in 2015. Reactive (positive) samples were screened by ELISA and then checked with two rapid reagents.Western blotting (WB) was used to confirm the results. Uncertain samples were follow-up in time or further carried out with nucleic acid detection. Results Among the 533 HIV positive samples, 495 were confirmed by WB, the positive coincidence rate was 92.9%, and 7 uncertain samples were positive by nucleic acid test. Compared with WB method, when ELISA S/CO > 6.67, the positive predictive value was 99.2%. Conclusion The positive coincidence rate of ELISA increased with the increase of S/CO value. When S/CO > 6.67 by ELISA and both rapid tests are positive, 98.57% WB confirmation test can be replaced and the coincidence rate with WB or nucleic acid test is 100%. Under the premise of guaranteeing the quality of detection, the cost of detection can be reduced and the detection time can be shortened.