云南省艾滋病快速检测替代策略推广运用情况分析

Application and promotion of rapid test as alternative strategy for HIV confirmation in Yunnan

目的分析云南省艾滋病快速检测替代推广运用情况,为全省艾滋病实验室网络建设及艾滋病抗体补充试验检测策略选择提供经验和科学依据。方法收集2018年全省艾滋病病毒(HIV)抗体筛查阳性样品补充试验检测策略选择情况及其检测结果,构建决策树模型,对传统确证检测(蛋白印迹试验,WB)和快速检测替代策略两种艾滋病抗体检测补充试验检测策略进行检测成本分析。结果2018年1-3月全省所有县(市、区)HIV抗体筛查阳性样品送检情况:具备确证能力和不具备确证能力县(市、区)的送样成本和获得确证检测结果时间,不具备和具备确证能力的县(市、区)送样成本分别为73元/份和31元/份,从首诊单位HIV抗体筛查阳性到获得确证结果报告的时间分别为10.6天和4.6天(含非工作日);每诊断出一份HIV抗体阳性样品,使用快速检测替代策略检测成本为58.93元,使用传统确证检测检测策略成本为487.00元。结论与传统确证检测检测相比,快速检测替代策略具有缩短检测结果反馈时间、降低检测成本等优点,适合进一步推广使用。

Objective To study the application and promotion of rapid test as an alternative for HIV confirmation in Yunnan and provide reference for development of HIV/AIDS laboratory network and the strategy choice for HIV supplementary test.Methods The data of HIV screening positive samples for supplementary testing and the results were collected from all the counties of Yunnan in 2018.The cost analysis was carried out for the traditional confirmation test(western blot,WB)and the rapid test as an alternative strategy by constructing decision tree model.Results From January to March 2018,the submission of positive samples for HIV screening showed that the cost of sample delivery from the counties with the labs for WB confirmatory ability and without were 73 yuan/case and 31 yuan/case,respectively;and the time for the confirmatory test results in the counties with the labs for confirmatory ability and without were 10.6 days and 4.6 days.As for each HIV positive sample diagnosed,the cost of using rapid test alternative strategy was 58.9 yuan and that of using the traditional confirmatory test(WB)strategy was 487.0 yuan.Conclusion Compared with the traditional confirmatory test(WB)strategy,the rapid test as an alternative has the advantages of short time and low cost to get the confirmation test results.It’s worth further promotion and wide application.