2017~2019年北京地坛医院HIV抗体检测结果分析

An Analysis of HIV Antibody Test Results in Beijing Ditan Hospital from 2017 to 2019

目的了解HIV抗体3年来在临床的流行趋势,发现和临床流行趋势相关的因素。方法总结2017年至2019年HIV抗体检测的结果,观察筛查阳性率有无变化,并结合性别年龄等因素分析流行变化趋势,同时对确证实验结果与筛查有反应的进行确证数据分析。结果检测总量逐年上升,但阳性率呈现下降趋势,2017年为3.12%,2018年为3.0%,2019年为2.49%。筛查有反应人群以皮肤性病和感染科为主,外科次之。以21到50岁青壮年人群为主,50岁以上中老年人群次之。感染者80%为男性,女性接近20%。筛查有反应做确证的比例逐年上升,从46%上升到62%。但确证阳性率呈下降趋势,从94%下降到了81%。确证试验阳性的筛查OD值94%以上在1.0以上,不确定和阴性的OD值以小于1.0为主,确证阳性和不确定的结果中都存在筛查实验单独P24抗原阳性的样本。结论随着我们国家对HIV感染防控力度的不断加大,不仅到医疗机构来做抗体筛查的人数在增加,而且筛查有反应的患者也能及时进行确证实验,筛查试验的结果值和确证的最终结果具有相关性。筛查有反应的患者分布科室较广,临床医生应强化意识,增加职业敏感性。除了对一般高危人群的青壮年男性加强防控之外,也应对老年男性人群和女性人群给予关注。

Objective To investigate the clinical epidemic trend of HIV antibody in the past three years,and to identify the related factors.Methods We summarized the results of HIV antibody testing from 2017 to 2019,also observed whether the positive rate of screening had changed,and further analyzed the trend of epidemic change combined with factors such as gender and age,as well as the confirmatory data of confirmation test results on screening reaction.Results The total amount of detection increased yearly,but the positive rate showed a downward trend,which was 3.12%in 2017,3.0%in 2018 and 2.49%in 2019.Patients who responded to the screening were mainly from Dermatology,Venereal disease and Infection department,followed by Surgery Department.Most of them were young people aged from 21 to 50 years old,followed by middle-aged and elderly people over 50 years old.80%of the infected people were male and nearly 20%were female.The proportion of screening reaction for confirmation increased yearly,from 46%to 62%.However,the positive rate showed a downward trend from 94%to 81%.More than 94%of the positive screening OD values of confirmatory test were above 1.0,and the OD values of uncertainty and negative were mainly less than 1.0.There were samples with p24 antigen positive in the screening test alone in the positive and uncertain results.Conclusion With the continuous efforts of HIV infection prevention and control in our country,not only the number of people who come to the medical institutions for antibody screening is increasing,but also the screening reaction patients can carry out the confirmation experiment in time.The result value of the screening test is related to the final result of confirmation.Clinical providers should strengthen awareness and increase occupational sensitivity.In addition to strengthening the prevention and control of young and middle-aged men in general high-risk groups,more attentions should also be paid to the elderly population.