HIV抗体不确定标本的鉴别诊断研究  

Verification of HIV Antibody Indeterminate Samples

作　　者：王海燕[1] 杨晓莉[1] 王莉[1] 马艳华[2] 曹广亚[3] 郭素菊[4] 辛武 陈激扬 李军 李清波 罗效梅 鲍作义[10] 李敬云[10] 

机构地区：[1]武警总医院艾滋病确认实验室,北京100039 [2]武警广东总队医院检验科,广东广州5105073 [3]武警上海总队医院检验科,上海201103 [4]武警湖北总队医院检验科,湖北武汉450052 [5]武警辽宁总队医院检验科,辽宁沈阳110034 [6]武警北京一总队医院检验科,北京100027 [7]武警北京二总队医院检验科,北京100037 [8]武警8650医院检验科,山西晋中030600 [9]武警重庆总队医院检验科,重庆400611 [10]军事医学科学院微生物流行病研究所,北京100085

出　　处：《中华医院感染学杂志》2009年第14期1900-1903,共4页Chinese Journal of Nosocomiology

基　　金：卫生部艾滋病防治应用性研究项目资助(WA-2006-07)

摘　　要：目的阐明HIV抗体不确定结果的血清学特征,比较条带免疫印迹法(LIA)、HIV病毒载量(VL)和HIV-1p24抗原检测3种实验方法对HIV不确定标本的鉴别效果,明确蛋白免疫印迹法(WB)的非特异性发生率,为修订我国艾滋病检测技术规范提供依据。方法检测56例HIV抗体不确定病例的92份标本,以随访后的HIV血清学状况为金标准,判断不同的方法在鉴别不确定结果方面的效果。结果92份标本中有88份呈现14种不确定的条带模式,p24、gp160以及gp160p24是最常见模式,其余9种呈散在分布;31例中27例随访阴性,4例发生HIV抗体阳转,阳转率26.7%;WB的非特异反应率87.1%,LIA的非特异反应率为3.2%,病毒载量的检测未出现非特异性反应,HIV-1P24抗原的漏检率为9.2%。结论只有出现gp160+p24带型的病例发生HIV抗体阳转,其余带型均表现为非异性反应,LIA、VL两种方法能够有效地判断现有的HIV不确定标本的感染状况。OBJECTIVE To study the serological characterization of HIV antibody indeterminate results, identify a new method to verify the HIV antibody indeterminate samples and provide references for editing National Guideline for Detection of HIV/AIDS. METHODS Line immunoassay （LIA）, HIV viral load （VL） test and Western blotting （WB） were monitored. RESULTS WB results showed that 44. 3% indeterminate HIV antibody samples were p24 monoband, 13.6% were gp160 monoband, 17% were gpl60 with p24 and 8% were p17 with p24. Four out of 31 cases were diagnosed as HIV primary infection. LIA and HIV RNA VL showed 4 serological changes which were confirmed to be HIV-positive. The other 27 cases without serological changes were proved to be HIV-negative. The specificity of LIA was 82.9%. p24 Antigen was negative in all the 31 cases, including the case which was confirmed as HIV-positive later. Of all 31 originally indeterminate cases, VL was tested in 30 cases. Positive results were found in 3 cases which were proved to be HIV-positive later. No VL was detected in the other 27 cases （〈CLDL）. CONCLUSIONS The most common band patterns of indeterminate HIV antibody are p24 monoband, gp160 monoband or gpl60 with p24. Nonspecificity of WB is 87. 1%, while only 3.2% nonspecificy occur using LIA method and none occurs using VL test. It shows that both LIA and VL test are efficient methods to discriminate indeterminate results.

关 键 词：艾滋病抗体 蛋白免疫印迹 条带免疫印迹 不确定 

分 类 号：R512.91[医药卫生—内科学]