广州市2020年不同人群HIV抗体确证结果分析

Confirmation of HIV antibody among subsets of Guangzhou populations 2020

目的:分析2020年广州市HIV抗体检测阳性样本的确证检测结果,了解确证样品的来源分布,感染人群的人口学特征等流行病学信息,为艾滋病预防和控制工作提供科学依据和参考。方法:对2020年广州市各HIV初筛实验室收集的阳性送确证样品采用酶联免疫吸附(ELISA)和蛋白免疫印迹法(WB)方法进行复检,严格按照试剂盒说明书进行操作和结果判定。结果:3719份HIV抗体检测阳性血清样品中,确证阳性2397份,占64.5%;确证结果为不确定的样品110份,占3.0%;阴性1212份,占32.6%。确证样品主要来源为一般医疗机构,占84.67%(3149/3719),不同来源样品的确证阳性结果分析,差异有统计学意义(P<0.05),其中确证阳性率最高为疾控中心、羁押及戒毒人员和健康关爱中心,确证阳性率分别是90.5%(258/285)、85.5%(47/55)和82.0%(91/111),最低为采供血机构(49.6%,59/119)。确证HIV-1阳性人群中男性占86.9%(2082/2397),平均年龄(39.4±14.4),文化程度以高中及以下为主,占71.2%(1707/2397),职业以商业服务、家务及待业和农民、民工和工人为主,占76.9%,婚姻状况以未婚占比最高,为48.1%(1152/2397),感染途径以同性传播占比最高(P<0.05)。结论:医疗机构是本地尽早发现艾滋病感染者的主要场所,在医院性病门诊开展VCT服务,有利于早期发现感染者,尤其如今艾滋病感染人群已经由高危人群向一般人群扩散,应加强对一般人群的检测力度,及早发现病例,减少HIV的传播。

Objective:To present the confirmation test results of HIV-positive samples in Guangzhou in 2020,so as to shed light on the sources of confirmed positive samples,demography of the infected and other epidemiological data,and to offer evidence for AIDS prevention and control.Methods:Enzyme-linked immunosorbent assay(ELISA)and Western blotting(WB)were used to re-examine the samples which tested positive at all HIV preliminary screening laboratories in Guangzhou and were scheduled for confirmation in 2020,in strict accordance with the instructions for manipulation of assay kits and interpretation of findings.Results:Among the 3719 previously HIV-positive serum samples,2397(64.5%)were confirmed positive,110(3.0%)were indeterminate,and 1212 were negative(32.6%).The samples with confirmed positivity were predominantly sourced from medical institutions[84.67%(3149/3719)].The positivity rate of the samples differed significantly with the sources(P<0.05).The confirmed HIV positivity was higher in samples from Guangzhou Center for Disease Control and Prevention[90.5%(258/285)],custody or drug rehabilitation units[85.5%(47/55)],and healthcare centers[82.0%(91/111)],and was lowest in samples from blood transfusion services(49.6%,59/119).Of the population subsets with confirmed HIV-1 positivity,males accounted for 86.9%(2082/2397);the mean age was(39.4±14.4)years;71.2%(1707/2397)were with an education level of secondary school or below;the occupations included business services,housework,and unemployed,farmers,migrant and professional workers(76.9%);the unmarried accounted for the highest proportion[48.1%(1152/2397)].Homosexuality was the predominant route of transmission(P<0.05).Conclusion:Medical institutions are the major place for early detection of HIV infection in local regions.Voluntary counseling and testing(VCT)services offered by venereal clinics in hospital may favor early detection of HIV infection.In particular,given that HIV infection has been extended from high-risk groups to the general population,efforts on HIV testing need to be reinforced to ensure early detection and reduction on the spread of HIV.