HIV-1抗体不确定患者追踪随访及其病毒载量分析

Follow-up and analysis of the viral load in patients with uncertain HIV-1 antibody

目的分析2017-2018年厦门市1型艾滋病病毒(HIV-1)抗体不确定病例的追踪随访情况,对病毒载量检测在鉴别HIV-1抗体不确定病例的效果进行分析评价。方法对随访到的61例HIV-1抗体不确定受检者的蛋白印迹试验(WB)的条带类型进行分析,并进行病毒载量检测。结果2017-2018年,HIV-1抗体不确定病例73例,随访61例。在不确定的带型中,env类的带型占比最高(47.5%,29/61),其中gp160带型出现14例,占比23.0%(14/61);gp160+gp120带型出现15例,占比24.6%(15/61)。病毒载量检测值低于检出限(20拷贝/mL)的占13.1%(8/61),全部转归阴性。病毒载量检测值高于检出限的病例占86.9%(53/61),全部转归阳性。结论病毒载量检测能够有效确定WB方法判断的不确定结果,是有效的鉴别HIV-1抗体不确定结果的实验方法,病毒载量检测能够作为HIV抗体检测补充实验的辅助手段,作为HIV-1抗体不确定病例的辅助诊断。

Objective To analyze the confirmed inconclusive results of HIV-1 antibody with Western Blot(WB),and to evaluate the effectiveness of HIV viral load test in identification of HIV antibody in the uncertain cases.Methods 61 HIV-1 antibody indeterminate serum samples were collected,tracked and analyzed on western blot bands pattern,and the results of HIV-1 viral load test were analyzed.Results There were 73 cases of indeterminate results by HIV confirmatory test,among which 61 cases were followed up from 2017 to 2018.Among the 61 cases,the type of env was the highest with 47.5%(29/61)of the 3 major structural antigens,in which the gp160+gp120 type accounted for 24.5%(15/61),and gp160 type for 23.0%(14/61).There were 8 samples(13.1%,8/61)with HIV-1 viral load testing results below the detection limit,and all of them were diagnosed as HIV antibody negative.53 samples(86.9%,53/61)with viral load values above the detection limit were all diagnosed as HIV-1 antibody positive after follow-up tests.Conclusion Viral load test can effectively determine the uncertain HIV-1 antibody by WB method,and it is effective to identify the uncertain HIV-1 antibody.Viral load detection can be used as a supplementary means for HIV-1 antibody detection.