云南省德宏傣族景颇族自治州49例人类免疫缺陷病毒抗体不确定者的追踪研究  

Follow-up of 49 human immunodeficiency virus antibody-indeterminate subjects in Dehong Dai and Jingpo Nationality Autonomous Prefecture of Yunnan Province

作　　者：杨锦 李丹[2] 王继宝 李艳玲 段星 项丽芬 叶润华 杨跃诚 龚渝蓉 高洁 蒋岩[2] 段松 

机构地区：[1]德宏傣族景颇族自治州疾病预防控制中心,芒市678400 [2]中国疾病预防控制中心性病艾滋病预防控制中心,传染病预防控制国家重点实验室,北京102206

出　　处：《微生物与感染》2013年第1期21-25,共5页Journal of Microbes and Infections

基　　金："十一五"国家科技重大专项(2008ZX10001-003)

摘　　要：通过分析云南省德宏傣族景颇族自治州(简称德宏州)2008～2011年49例采用蛋白免疫印迹法(WB)检测人类免疫缺陷病毒(HIV)抗体结果为不确定的标本,对人群分布、WB条带特点、随访复检情况及抗体转归情况进行探讨,揭示WB中可能存在的问题及改善措施。研究对象均来自德宏州疾病预防控制中心艾滋病确证实验室,依据《全国艾滋病检测技术规范》(2009年修订版)中的抗体检测替代策略和WB确证标准进行检测。结果显示,2008～2011年WB检测的2452份样本中,有2.00%(49/2452)为HIV抗体不确定,人员构成以自愿咨询检测者所占比例最大,占26.53%。S/CO值从大到小均有分布,但S/CO值≥10的样本复检阳性率较高,为83.33%(5/6)。WB结果呈现12种不确定的条带模式,以p24和gp160为主,其余10种呈散在分布。49例HIV抗体不确定者有27例成功进行了随访复检,其中8例HIV抗体复检转为阳性,转阳率为29.63%(8/27)。处于感染窗口期、临床期的患者及处于某些特定生理时期的正常人群都可能出现HIV抗体不确定的结果。因此,除对实验的各个环节严格进行质量控制及对出现不确定结果的受检者加强随访外,必要时应结合其他检测方法及流行病学调查辅助,从而作出准确诊断。A total of 49 subjects with human immunodeficiency virus （HIV） antibody-indeterminate in Dehong Dai and Jingpo Nationality Autonomous Prefecture of Yunnan Province from 2008 to 2011 were analyzed. The population distribution, Western blotting （WB） bands and follow-up results of antibody were investigated to reveal the existing problems and possible improvement. All the subjects were from the HIVConfirmatory Laboratory of Dehong Dai and Jingpo Nationality Autonomous Center for Disease Control and Prevention and the results were decided by the National Guideline for Detection of HIV/AIDS （2009 Edition）. 49 （2.00%） cases with indeterminate HIV antibody in 2 452 samples were found, mainly in the population of voluntary counseling and testing （26.53%）. The ratio of S/CO was distributed from 〈1 to ≥110, but the seroconversion rate of cases with S/CO≥10 was as high as 83.33% （5/6）. The main bands were p24 and gp160. 27 patients were successfully followed up, of which 8 turned positive. The positive conversion rate was 29.63% （8/27）. As indeterminate HIV antibody results may exist in window period of HIV infection in patients with other diseases and even healthy people in certain physiological periods, all the laboratory procedures need good quality control. Other detection methods and epidemiological survey of acquired immunodeficiency syndrome （AIDS） should be combined to make accurate diagnosis.

关 键 词：人类免疫缺陷病毒1型感染 蛋白免疫印迹试验 酶联免疫吸附试验 蛋白免疫印迹带型 不确定 

分 类 号：R446.6[医药卫生—诊断学]