人类免疫缺陷病毒高值假阳性样本2例分析报告

Analysis report of two false positive samples with high HIV values

目的对山西省长治市人民医院检验科2022年化学发光法筛选出的人类免疫缺陷病毒(HIV)高值假阳性患者2例血清样本进行分析报告。方法2份标本均采用直接化学发光法(CMIA法)复检,对其进行干扰原因分析,使用类风湿因子(RF)测定试剂盒测定RF,用2-巯基乙醇、异嗜性抗体封闭管、6%的聚乙二醇和12%的聚乙二醇处理样本后用HIV抗原抗体检测试剂盒复检。结果2份样本CMIA法结果为有反应,经过处理后结果降为阴性。结论样本1中干扰物质可能同时与P24-Fab端和P24-Fc端产生非特异性吸附,导致检测结果为假阳性,而2-巯基乙醇可以破坏干扰物质,6%聚乙二醇(PEG6000)和12%PEG6000可以沉淀干扰物质,因此处理后结果将为阴性;样本2可能是由于异嗜性抗体吸附P24-Fc端、HIV-Ⅱ型抗原以及磁珠产生的假阳性,根据PEG6000处理后的结果推测异嗜性抗体存在IgM型和IgG型。

Objective The purpose of this study is to analyze and report on two false positive samples with high HIV values screened by chemiluminescence immunoassay(CMIA)in the laboratory of Changzhi People′s Hospital,Shanxi Province in 2022.Methods Both serum samples were retested by direct chemiluminescence(CMIA)method,and interference causes were analyzed.Rheumatoid factor(RF)was determined with a RF assay kit,and samples were treated with 2-mercaptoethanol,heterotropic antibody closed tube,6%PEG6000 and 12%PEG6000,and then retested with a human immunodeficiency virus antigen antibody assay kit.Results The results of direct chemiluminescence(CMIA)were positive,but the results were negative after treatment.Conclusion The interfering substances in sample 1 may have non-specific adsorption with P24-Fab terminal and P24-Fc terminal at the same time,resulting in false positive results.However,2-mercaptoethanol can destroy interfering substances,and 6%PEG6000 and 12%PEG6000 can precipitate interfering substances,so the results will be negative after treatment.Sample 2 may be the result of the false positive generated by the adsorption of P24-Fc terminal,HIV-Ⅱantigen and magnetic beads by heterophil antibodies.According to the results of PEG6000 treatment,it is speculated that the heterophil antibodies exist in IgM and IgG types.