4种快速联合检测替代策略在WB抗体不确定者中诊断HIV感染的应用

An alternative strategy on joint detection of four rapid tests for HIV confirmation among patients with HIV antibody indeterminate

目的 探讨4种快速试剂联合检测替代策略在WB抗体不确定者中诊断HIV感染的可行性。方法 对2021年1月—11月玉溪市疾病预防控制中心经蛋白印迹检测的20例HIV抗体不确定样本,进行核酸检测和4种快速试剂联合检测替代试验,并比较检测结果一致性。其中4种快速检测试剂联合检测替代试验结果判定标准:4种快速检测试剂均为强阳性反应,判定为“HIV抗体阳性”;只要其中一种无反应或反应较弱,判定为“HIV感染待确定”;4种快速检测试剂均为阴性反应,判定为“HIV抗体阴性”。结果 20例不确定样本经4种快速检测试剂联合检测,6例判为“HIV抗体阳性”,8例判为“HIV抗体阴性”,6例判为“HIV感染待确定”,病毒载量检测中,6例>5 000拷贝/ml, 14例均低于检测限。联合检测结果与核酸检测的阳性结果一致性为100%。结论 4种快速联合检测替代策略可在抗体不确定者中辅助诊断HIV感染。

Objective This paper aims to explore the feasibility of the four rapid tests as an alternative for HIV confirmation among patients with HIV antibody indeterminate detected by Western blot(WB). Methods There were 20 cases confirmed as HIV antibody indeterminate detected by WB in Yuxi Municipal Center for Disease Control and Prevention from Janauary 2021 to November 2021, which were tested with nucleic acid detection and four rapid tests as an alternative for HIV confirmation. The determination criteria for the replacement test results of the combined detection of 4 kinds of rapid detection reagents were as follows: 4 kinds of rapid detection reagents were strongly positive and were determined as “HIV antibody positive”;as long as one of them has no response or weak response, it is judged as “HIV infection to be determined”;the four rapid detection reagents were all negative and were judged as “HIV antibody negative”. Results Twenty indeterminate samples were tested by four kinds of rapid detection reagents of which 6 cases were defined as “HIV antibody positive”, 8 cases defined as “HIV antibody negative” and 6 cases defined as “HIV infection to be determined”. In the nucleic acid detection for HIV confirmation, 6 cases were with viral load more than 5 000 cp/ml and 14 cases were below the detection limit, and the consistency of two methods was 100%. Conclusion The four rapid tests as an alternative for HIV confirmation could be an auxiliary diagnosis for indeterminate cases of HIV antibody.