多种补充试验对HIV抗体不确定样本的诊断效果比较

Comparison of diagnostic effects of multiple supplementary tests for indeterminate HIV antibody samples

目的对比分析重组免疫印迹试验(RIBA)、蛋白印迹试验(WB)、联合抗体确证试验(RIBA+WB)及HIV-1病毒载量(VL)试验在HIV抗体不确定样本中的检测结果,为不确定样本提供准确快速的诊断策略。方法对2015年—2019年衢州市艾滋病确证实验室首次抗体补充试验(RIBA或WB)即检测为HIV抗体不确定样本,进行2种抗体补充试验(RIBA和WB)和VL试验回顾性检测分析,并比较四者的检测结果。结果30份HIV抗体不确定样本,单独使用RIBA或WB检测,可分别诊断HIV-1抗体阳性6份(20.0%)和14份(46.7%),两者阳性检出率差异有统计学意义(χ^(2)=4.8,P<0.05);而采用联合抗体确证试验可诊断HIV-1抗体阳性20份,10份不确定,三者阳性检出率差异有统计学意义(χ^(2)=13.32,P<0.05)。结论在HIV抗体不确定样本的诊断中,WB更适合作为抗体补充试验的首选方法,联合抗体确证试验可以有效提高HIV感染的诊断率;国产试剂RIBA是一种值得信赖的检测方法。

Objective To provide exact diagnostic strategies for indeterminate HIV antibody samples by comparing and analyzing the results of recombinant immunoblot assay(RIBA),western blot(WB),combined antibody detection(RIBA+WB)and HIV-1 viral load test in samples with indeterminate HIV antibody detection result.Methods The indeterminate HIV antibody samples detected by initial antibody supplement test from Quzhou AIDS Confirmative Laboratory's(RIBA or WB)from 2015 to 2019 were conducted for two antibody supplement tests(RIBA and WB)and VL test,and retrospective analysis was performed.The test results of the four subjects were compared.Results Thirty cases of indeterminate HIV antibody samples were detected by RIBA and WB respectively,of which 6(20%)and 14(46.7%)were confirmed as HIV antibody-positive,and the differences in the positive detection rate was statistically significant(χ^(2)=4.8,P<0.05);while using the combined antibody test,20 positive HIV-1 antibody samples were diagnosed,10 of which were indeterminate,and there was statistical significance on the difference in the positive detection rate among the three methods(χ^(2)=13.32,P<0.05).Conclusion In the diagnosis of indeterminate HIV antibody samples,WB is more suitable as the preferred method for antibody supplementation testing,and combined detection of antibodies can effectively improve the diagnosis rate of HIV infection;domestic reagent RIBA is a trustworthy detection method.