安徽省艾滋病监测哨点HCV筛查抗体阳性样本补充试验与病毒载量检测结果分析

Result analysis of antibody supplementation test and viral load test for positive samples of hepatitis C screening based on AIDS sentinel surveillance point in Anhui

目的了解安徽省艾滋病监测哨点丙型肝炎(简称丙肝)病毒(HCV)阳性者在各类人群的分布情况,并对HCV检测实验室常用的抗体检测与核酸检测方法进行分析。方法以2016年安徽省艾滋病监测哨点HCV酶联免疫法(EIA)检测阳性的370例标本为研究对象,进行HCV抗体补充试验,样本量足够的情况下进行HCV核糖核酸(RNA)定量检测,结合流行病学资料进行分析。结果对369例EIA检测HCV阳性标本进行重组免疫印迹试验(RIBA),阳性率99.2%(366例),其中注射吸毒人群占90.4%(331/366),暗娼占4.1%(15/366),性病门诊就诊者占3.0%(11/366),流动人口占1.4%(5/366),孕产妇占0.8%(3/366),男男性行为者占0.3%(1/366);344例样本量足够的标本进行了HCV RNA定量检测,阳性率82.6%(284/344),丙肝核酸阴转率为17.4%(60/344),对RIBA阳性结果的标本进行分条带统计,其中核抗原区出现概率最高,达到99.7%(365/366),其次为NS3-1、NS3-2和NS5,NS4出现概率最低,仅为85.8%(314/366)。结论我省艾滋病哨点中HCV感染和患病者集中在吸毒人群,是防治的最主要人群;HCV EIA检测阳性的标本可直接进行核酸检测,不必进行抗体补充试验,以减少检测成本;但核酸结果与抗体和临床症状相悖时也应考虑随访检测。

Objective To investigate the distribution of hepatitis C virus positive people in different groups in Anhui province,and analyze the antibody detection and nucleic acid detection methods commonly used in HCV testing laboratory.Methods In 2016,a total of 370 samples of HCV screened positives by ELISA based on Anhui AIDS sentinel surveillance received HCV antibody supplementation test,and HCV RNA quantitative detection was carried out with sufficient size of samples.All the results were analyzed with epidemiological data.Results Recombinant immunoblot assay(RIBA)was performed on 369 EIA HCV positive samples,with a positive rate of 99.2%(366 cases).Among them,injection drug users accounted for 90.4%(331/366),female sex workers for 4.1%(15/366),and STD clinic patients for 3%(11/366),the floating population for 1.4%(5/366),the pregnant women for 0.8%(3/366),and MSM for 0.3%(1/366).344 cases of sufficient sample size were studied by HCV RNA quantitative detection,with the positive rate of 82.6%(284/344),and hepatitis C virus nucleic acid negative rate of 17.4%(60/344).The samples with positive RIBA results were analyzed by banding,and the probability of nuclear antigen region was the highest,reaching 99.7%(365/366),followed by NS3-1,NS3-2 and NS5.NS4 had the lowest probability,only 85.8%(314/366).Conclusion Injecting drug users is the main group infected with hepatitis C based on the AIDS sentinel surveillance point in Anhui province,which should be the main target group for HCV prevention and control.Positive samples of HCV ELISA can be tested directly for nucleic acid detection.There is no need for antibody supplement test,in order to reduce the detection cost.However,follow-up testing should be considered when nucleic acid results are inconsistent with antibodies and clinical symptoms.