31例HIV-1抗体不确定疑难样本补充试验结果分析

Analysis of supplement test results of 31 cases of WB follow-up with uncertain and difficult samples

目的通过分析1型艾滋病病毒(HIV-1)抗体随访不确定样本补充试验结果,为首次HIV-1抗体不确定者补充试验的选择提供依据。方法对31例蛋白免疫试验(WB)结果不确定的样本,均于2~4周后进行WB复检,同时进行HIV-1核糖核酸(RNA)定量检测(PCR-荧光法),对于≤5000 cps/mL的样本间隔2~4周进行WB随访检测。结果31例WB不确定样本中,核酸定量检测结果>5000 cps/mL的样本5例,结果为未检出的样本26例。>5000 cps/mL的样本中3例WB条带发生进展、1例多次WB条带无进展但定量检测结果为高值;1例定量检测结果为1050 cps/mL样本,经过2次2~4周后随访WB条带有进展。来自VCT和其他来源样本HIV感染差异有统计学意义(Fisher’s精确概率P<0.05),性别间HIV感染差异有统计学意义(χ^2=3.886,P<0.05)结论核酸定量检测可以快速有效地对疑难样本进行鉴别诊断,患者应根据个人需求自主选择补充试验方法进行明确诊断。

Objective To analyze the results of the supplement test of the follow-up uncertain samples of type 1 AIDS virus(HIV-1) antibody,provide the basis for the selection of the supplement test for the first time HIV-1 antibody not confirmed.Methods For the 31 samples with uncertain results of protein immunity test(WB),all the samples were reexamined by WB after 2~4 weeks,and quantitative detection of HIV-1 RNA(pcr-fluorescence method) was also conducted.For the samples ≤5 000 cps/mL,follow-up detection of WB was conducted for 2~4 weeks.Results Among the 31 uncertain samples of WB,the nucleic acid quantitative test results were greater than 5 000 cps/mL in 5 cases,and the results were undetected in 26 cases.Among the samples>5 000 cps/mL,3 cases of WB band progressed,1 case of multiple WB band did not progress,but the quantitative detection result was high.The quantitative test result of 1 case was 1 050 cps/mL,and the WB strip was followed up for 2~4 weeks.There was a statistically significant difference in HIV infection between samples from VCT and samples from other sources(Fisher’s exact probability P<0.05).There was a statistically significant difference in HIV infection between the sexes(χ^2=3.886,P<0.05).Conclusion The quantitative detection of nucleic acid can quickly and effectively differentiate the difficult samples.Patients should independently choose two supplementary experiments according to their personal needs to clarify the diagnosis.