2019—2022年泸州市HIV-1抗体阴性和不确定确证结果与核酸定量检测结果一致性分析

Consistency analysis between negative and uncertain confirmation results and quantitative nucleic acid testing results of HIV-1 antibody in Luzhou City from 2019 to 2022

目的 分析HIV-1抗体阴性和不确定确证结果与HIV-1核酸定量检测结果的一致性,探讨抗体确证为HIV-1阴性和不确定血清标本进行核酸检测的必要性。方法 收集2019年1月至2022年6月抗体确证为HIV-1阴性和不确定的血清标本,进行HIV-1核酸定量检测,采用Excel 2013、SPSS 25.0软件进行描述性统计学分析,率的比较采用χ^(2)检验,检验水准(双侧检验)为0.05。结果 875份血清标本中有228份核酸定量检测大于5 000 Cps/ml,其年龄均值为56.39,男女比例为2.26∶1,46.93%(107/228)为大于50岁的男性血清标本;医院、疾控、妇幼机构的血清标本分别有35.64%(129/362)、24.01%(97/404)和1.83%(2/109)核酸定量检测大于5 000 Cps/ml;无论筛查S/CO数值高低及抗体确证检测情况,各组均有HIV-1核酸定量检测值大于5 000 Cps/ml的血清标本。结论 筛查S/CO值比较或抗体确证检测结果均不能完全有效区分是否感染HIV,使用灵敏度更高的筛查试剂进行初步的抗体筛查,再使用特异性更高的抗体确证试剂检测,HIV-1抗体阳性可以直接诊断HIV感染,而HIV-1抗体阴性和不确定血清标本再进行HIV核酸检测可最大程度的发现感染者,减少传播。

Objective To analyze the consistency of the negative and uncertain HIV-1 antibody confirmation results and the quantitative HIV-1 nucleic acid testing results,and to investigate the necessity of nucleic acid test for HIV-1 negative and uncertain serum samples confirmed by antibodies.Methods Samples confirmed to be negative and uncertain for HIV-1 from January 2019 to June 2022 were collected for quantitative HIV-1 nucleic acid testing and descriptive statistical analysis by Excel 2013 and SPSS 25.0 software.χ^(2)test was used to compare the rates,and the test level(bilateral)was 0.05.Results Among 875 serum samples,there were 228 samples with quantitative nucleic acid testing results greater than 5000 Cps/ml.The mean age was 56.39 years old,and the male to female ratio was 2.26∶1.There were 107(46.93%)serum samples of men over 50 years old.There were 35.64%(129/362),24.01%(97/404)and 1.83%(2/109)of serum samples from hospitals,disease control institutions and maternal and child institutions with quantitative nucleic acid testing results greater than 5000 Cps/ml,respectively.Regardless of the value of screening S/CO and the antibody confirmation and detection status,samples with HIV-1 viral load detection value greater than 5000 Cps/ml were available in each group.Conclusions Neither screening S/CO value comparison nor antibody confirmation testing results were fully effective in distinguishing HIV infection.The use of more sensitive screening reagents for preliminary antibody screening,and then the use of more specific reagents for antibody confirmation detection,with HIV-1 antibody positive directly diagnosed as HIV infection,while HIV-1 antibody negative and uncertain samples underwent HIV nucleic acid detection can maximize the detection,reduce transmission.