人类嗜T淋巴细胞病毒抗体血清学筛查与确证试验的相关性分析

Correlation between serological screening of human T-lymphotropic virus antibodies and confirmatory tests

目的探讨广州献血人群抗-HTLV血清学筛查与免疫印迹确证试验结果的相关性,了解广州地区HTLV-Ⅰ/Ⅱ感染情况。方法采用抗-HTLVⅠ/ⅡELISA试剂对2016年7月—2022年8月广州血液中心采集的无偿献血者进行筛查,395份ELISA反应性的献血者标本经免疫印迹法(WB)进行确证;使用ROC曲线分析抗-HTLVⅠ/ⅡELISA检测的S/CO值与WB确证试验结果的相关性,分析广州献血人群HTLV-Ⅰ/Ⅱ感染情况。结果395份ELISA反应性的献血者标本经WB确证有25份为HTLV阳性,不确定16份;ROC曲线分析显示ELISA检测的S/CO值与WB确证试验结果具有相关性:Youden指数最大时的S/CO值3.789为最佳阈值,ELISA检测的S/CO值与预测WB确证结果阳性率有一定相关性(P<0.05),S/CO值越大,阳性预测值越高;广州地区HTLV总体感染率较低。结论广州地区献血人群HTLV流行率低;抗-HTLV-Ⅰ/ⅡELISA血清学筛查假阳性率较高,确证试验尤为重要。

Objective To explore the correlation between serological screening of human T-lymphotropic virus antibodies(anti HTLV)and Western blot(WB)confirmatory tests among blood donors,so as to explore the infection status of HTLVⅠ/Ⅱ in Guangzhou.Methods The anti HTLVⅠ/Ⅱ enzyme-linked immunosorbent assay(ELISA)kit was used to screen voluntary blood donors from Guangzhou Blood Center from July 2016 to August 2022.WB was used to confirm 395 reactive blood samples by ELISA.The correlation between the S/CO values of anti HTLVⅠ/Ⅱ ELISA reagents and the confirmatory test was analyzed using ROC curves.Results The results showed that 25 out of 395 initially screened reactive blood donor samples were confirmed as HTLV positive by WB,while 16 were uncertain.ROC curve analysis showed a correlation between the S/CO values by ELISA and the confirmatory test results:the S/CO value at the highest Youden index was 3.789,which was the optimal threshold.The S/CO value had a certain correlation with the predicted positive rate of confirmatory results(P<0.05):the larger the S/CO value,the higher the predicted positive value.The overall prevalence of HTLV in Guangzhou is relatively low.Conclusion The prevalence of HTLV among blood donors in Guangzhou is low.Since the false positive rate of HTLVⅠ/Ⅱ antibody by ELISA serological screening is high,the confirmatory testing is particularly important.