2019年深圳市HIV确证非阳性样本核酸检测结果分析

Analysis of nucleic acid test results of non⁃positive HIV confirmed samples in Shenzhen in 2019

目的对深圳市2019年HIV确证试验结果为非阳性的样本进行核酸检测并分析结果,为艾滋病确诊及防控提供数据支持。方法采集深圳市2019年HIV筛查试验有反应性而确证试验结果为不确定或阴性的样本,进行HIV-1核酸检测。结果确证试验结果为不确定的样本277例,检出核酸阳性67例,行政区域、性别、样本来源的核酸阳性率比较,差异有统计学意义(P<0.05)。确证试验结果为阴性的样本624例,检出核酸阳性13例,性别的核酸阳性率比较,差异有统计学意义(P<0.05)。确证试验结果为阴性的样本中,不同筛查方法的核酸阳性率比较,差异有统计学意义(P<0.05)。确证试验结果为不确定和阴性样本的核酸检测结果比较,差异有统计学意义(P<0.05)。核酸阳性和未检出样本的CD4+T淋巴细胞计数比较,差异有统计学意义(P<0.05)。单条带带型总体核酸阳性率较低(3.8%),多条带带型中同时包含gp160和gp120(75.0%)或gp160和p24(72.5%)的核酸阳性率较高。结论对于筛查试验结果阳性而确证试验结果为非阳性的样本,核酸检测可以有效提高HIV的检出效率。

Objective To test HIV viral load for samples with non⁃reactive western blot(WB)re⁃sults in Shenzhen in 2019,and provide data support for diagnosis and control of HIV.Methods Samples were collected from Shenzhen in 2019.Those samples were responsive in the HIV screening test and confirmed that the test results are indeterminate or negative for WB results.The viral loads were tested by HIV⁃1 nucleic acid testing in Shenzhen in 2019.Results There were 67 RNA positive samples out of 277 samples with un⁃certain WB results,and the differences were statistically significant in the RNA positive rate for administrative region,gender and source(P<0.05).The confirmation test results were negative in 624 samples,and 13 nucleic acid⁃positive cases were detected.There was a statistically significant difference in the nucleic acid⁃positive rate of gender(P<0.05).Among the samples with negative confirmation test results,the difference in the positive rate of nucleic acid of different screening methods was statistically significant(P<0.05).The confirmation test results were compared with the nucleic acid test results of the uncertain and negative samples,and the differ⁃ence was statistically significant(P<0.05).There was a statistically significant difference in the counts of CD4+T lymphocytes between nucleic acid⁃positive and undetected samples(P<0.05).The overall nucleic acid posi⁃tive rate of single⁃band type is low(3.8%),and the positive rate of nucleic acid that contains both gp160 and gp120(75.0%)or gp160 and p24(72.5%)in multiple⁃band type is higher.Conclusion For samples that have a positive screening test result but confirm that the test result is non⁃positive,nucleic acid testing can effective⁃ly improve the detection efficiency of HIV.