我国现行HIV抗体检测策略的评价  

Evaluation of HIV Antibody Test Strategy Currently Used in China

作　　者：郝钦芳[1] 杨京民 马艳华[3] 张丽萍[1] 王贝晗[1] 罗效梅 王述莲[5] 谢淼[6] 杨晓莉[1] 

机构地区：[1]武警总医院检验科,北京100039 [2]武警北京一总队医院检验科,北京100027 [3]武警广东总队医院检验科,广东广州5105073 [4]武警重庆总队医院检验科,重庆400611 [5]武警北京总队三师医院检验科,北京100039 [6]武警贵州总队医院检验科,贵州贵阳550005

出　　处：《中华医院感染学杂志》2010年第14期2018-2021,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：目的明确我国现行人类免疫缺陷病毒(HIV)抗体检测策略在实际使用过程中存在的主要问题,全面评价现行HIV抗体检测策略在筛查、复检、确认、随访的作用和效果。方法对武警总医院1999-2008年124 864例的临床就诊患者、2003-2008年160 747名的应征青年及2007年14所武警系统艾滋病检测网络实验室的32 530例患者,共计约31万份HIV抗体检测数据进行回顾性分析;对HIV不确定病例的首次血清样本进行HIV抗体条带免疫印迹法(LIA)、HIV RNA病毒载量检测,以随访的结果为金标准,评价核酸检测的方法在确认HIV感染和诊断窗口期感染方面的效果。结果不同人群中HIV抗体阳性率差异显著,应征青年体检人群为0.0019%、临床就诊患者为0.039%、吸毒人群最高,达到4.1%;不同人群HIV抗体的确认效率显著不同,临床就诊人群的确认效率最低,只有48.9%、青年体检人群为73.5%、吸毒人群的确认效率最高,达到了100.0%;HIV抗体首次筛查阳性的真阳性率由2004年的3.7%上升到2008年的13.5%,筛查的准确性提高了4倍,复检效率由2002年的100.0%,下降到2008年的61.5%;31例不确定病例中HIV真阳性率为12.9%。结论 HIV感染率和不确定发生率在不同的人群中显著不同。现行的检测策略需要进行必要的调整。OBJECTIVE To evaluate the HIV antibody test strategy and provide references for editing the National Guideline for Detection of HIV/AIDS.METHODS Totally about 310 000 copies of HIV antibody testing data were retrospely analyzed.The interval of the medical observation on 310 000 cases of HIV indeterminate samples,and the effects of nucleic acid test in identifying the HIV infection and diagnosing the window period were evaluated.RESULTS HIV positive rate in different population,were significanthy different,the new recruits were 0.0019%,the clinical patients were 0.039%,and the drug users were the highest,up to 4.1%.Different populations to confirm the efficiency of HIV antibody were significantly different.The confirmed rate of the clinical groups were the lowest only 48.9%,that of the youth groups was 73.5%,drug groups were with the highest confirmed rate,reached to 100%.HIV antibody screening positive for the first time,the real positive rate in creased from 3.7% in 2004 to13.5%,in 2008,the accuracy of the screening was four-fold increased.The review efficiency was down to（61.5%） in 2008 from（100.0%） in 2002 31 cases were follow-up,from them 4 were with HIV infection and the remaining 27 cases（87.1%） were with non-specific reaction.CONCLUSIONS The HIV prevalence in different populations are significantly different.The current testing strategies should be performed with necessary adjustments.

关 键 词：人类免疫缺陷病毒抗体 策略 蛋白免疫印迹 

分 类 号：R512.91[医药卫生—内科学]