限制性抗原亲和力酶联免疫法和集合核酸法检测用于云南省哨点监测男男性行为人群HIV-1新发感染的研究

Performance of limiting-antigen avidity enzyme immunoassay and pooling PCR in detection of recent HIV-1 infection among men who have sex with men in Yunnan province

目的比较限制性抗原亲和力酶联免疫法(LAg-Avidity EIA)和集合核酸法评估MSM的HIV-1新发感染率的可行性。方法对2016-2017年云南省13个州(市)MSM哨点监测采用滚雪球方法采集样本进行HIV-1抗体检测,确证阳性样本进行LAg-Avidity EIA检测,HIV-1抗体阴性样本进行集合核酸法检测,分别采用LAg-Avidity EIA新发感染算法和集合核酸法检测新发感染算法计算HIV-1新发感染率,并进行结果的比较。结果研究样本共计5363份,其中HIV-1抗体阳性样本407份(含既往阳性177份),HIV-1抗体阴性样本4956份,完成LAg-Avidity EIA检测211份(91.7%),判为新近感染69份;完成集合核酸法检测4469份,判定为HIV-1感染窗口期8份。LAg-Avidity EIA估算的2016年和2017年HIV-1新发感染率分别为3.36%和4.84%,集合核酸法估算的HIV-1新发感染率分别为3.27%和3.02%,2种方法估算的HIV-1新发感染率差异无统计学意义。结论LAg-Avidity EIA和集合核酸法估算得到2016-2017年云南省哨点MSM HIV-1新发感染率一致性较好,2种方法用于HIV-1新发感染率的连续监测会有较好的稳定性。

Objective To assess and compare the performance of limiting-antigen avidity enzyme immunoassay(LAg-Avidity EIA)and pooling PCR in the surveillance for recent infection rates of HIV-1 in men who have sex with men(MSM).Methods Blood samples were collected from MSM selected through snowball sampling method in sentinel surveillance in 13 prefectures of Yunnan province from 2016 to 2017.The samples were tested for HIV-1 antibody.The confirmed positive samples were tested by LAg-Avidity EIA.The negative samples were tested by pooling PCR.The recent infection rates of HIV-1 were estimated by the algorithm based on LAg-Avidity EIA and pooling PCR respectively.The two results were compared.Results During 2016-2017,a total of 5363 blood samples were collected from MSM,in which 407 samples were HIV-1 positive(including 177 positive tested previously)and 4956 samples were HIV-1 negative.A total of 211 samples(91.7%)were tested by LAg-Avidity EIA,69 were confirmed to be recent infections.A total of 4469 samples were tested by pooling PCR,8 were confirmed to be acute infections.The recent infection rates of HIV-1 from 2016 to 2017 estimated by LAg-Avidity EIA were 3.36%and 4.84%,and the recent infection rates estimated by pooling PCR were 3.27%and 3.02%respectively.The differences in recent infection rates of HIV-1 estimated by the two algorithms were not significant.Conclusions The recent infection rates of HIV-1 estimated by LAg-Avidity EIA and pooling PCR in sentinel surveillance in MSM in Yunnan had good consistency from 2016 to 2017.Using the two methods might have a better stability in continuous surveillance for recent infection rates of HIV-1.