核酸定量检测试验应用于HIV-1感染实验室诊断的探讨

目的:探讨核酸定量检测在HIV-1感染实验室诊断中的应用。方法:选取145例第四代抗原/抗体联合诊断筛查试验为阳性反应的血浆样本,分别用Western印迹和HIV-1核酸定量方法进行检测,综合对比分析2种方法检测结果。结果:Western印迹检出阳性样本120例,不确定样本17例,阴性样本8例;HIV-1核酸定量试验检出结果大于检测限样本131例,其中包括12例Western印迹不确定样本、2例Western印迹阴性样本;有3例Western印迹阳性样本用HIV-1核酸定量检测试验未能检出。结论:核酸定量检测试验对于HIV-1感染阳性样本是一种有效的实验室诊断方法;对HIV-1核酸定量检测结果为"TND"的样本,建议加做Western印迹或结合其他补充试验结果进行综合诊断。

2015-2017年中国HIV暴露儿童艾滋病感染早期诊断检测情况分析

目的分析我国HIV暴露儿童接受儿童艾滋病感染早期诊断(early infant diagnosis,EID)检测服务情况并探讨其相关影响因素。方法利用全国预防艾滋病母婴传播管理信息系统,收集HIV感染孕产妇分娩儿童随访卡,回顾性分析我国2015-2017年随访满18月龄的12 096例HIV暴露儿童队列数据。描述HIV暴露儿童EID检测特征,分析EID检测相关影响因素。结果2015-2017年我国HIV暴露儿童EID检测率自65.6%增加至83.4%(趋势性χ^2检验P<0.001),出生后8周内EID检测比例自61.1%增加至76.8%(趋势性χ^2检验P<0.001),EID检测阳性率自8.7%降低至3.4%(趋势性χ^2检验P<0.001)。2015-2017年死亡儿童EID检测阳性率分别为47.7%、36.9%和36.3%,差异无统计学意义。多因素分析发现HIV暴露儿童民族、地区、满18月龄和存活情况与接受EID检测之间存在关联,差异有统计学意义(P<0.001)。结论我国EID检测工作逐步规范落实,EID检测阳性率逐年降低,但18月龄内死亡儿童,少数民族和HIV低发区儿童的EID检测比例较低。

Role of upper endoscopy in diagnosing opportunistic infections in human immunodeficiency virus-infected patients

Highly active antiretroviral therapy (HAART) has dramatically decreased opportunistic infections (OIs) in human immunodef iciency virus (HIV)-infected patients. However,gastrointestinal disease continues to account for a high proportion of presenting symptoms in these patients. Gastrointestinal symptoms in treated patients who respond to therapy are more likely to the result of drug-induced complications than OI. Endoscopic evaluation of the gastrointestinal tract remains a cornerstone of diagnosis,especially in patients with advanced immunodeficiency,who are at risk for OI. The peripheral blood CD4 lymphocyte count helps to predict the risk of an OI,with the highest risk seen in HIV-infected patients with low CD4 count (< 200 cells/mm3). This review provides an update of the role of endoscopy in diagnosing OI in the upper gastrointestinal tract in HIV-infected patients in the era of HAART.