集合核酸检测用于低档场所女性性工作者HIV急性感染诊断及发病率估计  

The role of RNA pooling technique in the diagnosis of acute HIV infection and the estimation onHIV incidence among low-grade-venues female sex workers

作　　者：李剑军[1] 张鸿满[1] 沈智勇[1] 周月姣[1] 方宁烨[1] 王斌[1] 王江伟[1] 唐振柱[1] 

机构地区：[1]广西壮族自治区疾病预防控制中心艾滋病防制所,南宁530028

出　　处：《中华流行病学杂志》2014年第3期259-261,共3页Chinese Journal of Epidemiology

基　　金：广西科学研究与技术开发计划项目（桂科攻1298003-1-4）

摘　　要：目的评价集合核酸检测方法在低档场所女性性工作者（FSWs）HIV急性感染诊断中的应用价值。方法对广西壮族自治区2011年低档场所FSWs进行调查，并采集血液，采用胶体硒法对HIV抗体初筛检测；对初筛阴性者采用集合核酸检测方法检测HIVRNA，若为阳性，3个月内随访并采集血液进行确汪；应用估算公式计算HIV年发病率。结果共收集6469例FSWs的血液样本，HIV抗体初筛阳性139例，阳性率为2．15％。对6330例初筛阴性者进行集合核酸检测，7例为HIVRNA阳性。3个月内随访检测，6例出现HIV-1抗体阳转，诊断为HIV急性感染者。2011年广两低档场所FSWs的HIV年发病率为1．45（95％CI：1．17—1．76）／100人年。结论集合核酸检测用于HIV传播的高危人群检测可以发现急性感染者。Objective To examine the feasibility of RNA pooling technique in the diagnosis on acute HIV infection among female sex workers （FSWs） working at the low-grade venues. Methods Plasma samples from the low-grade-venue FSWs in Guangxi, in 2011 were tested for HIV antibody using the rapid testing method. All samples which were HIV antibody negative in the rapid testing were tested for HIV RNA with RNA pooling technique. FSWs who showed HIV RNA positive were tested for HIV antibody by Western blot method in 3 months. The HIV incidence in the low-grade venue FSWs was counted under the estimation formula. Results There were 6 469 cases of FSWs who were recruited in this study. Through rapid testing, results showed that HIV antibody was positive in 139 cases, with the positive rate as 2.15%. 6 330 FSWs with HIV antibody negative were tested by HIV RNA pooling method, with 7 of them showing HIV RNA positive, in which 6 cases showed HIV-1 antibody seroconversion, thus were diagnosed as acute HIV infection. HIV incidence in low-grade FSWs appeared to be 1.45 per 100 person years （95%CI： 1.17-1.76 per 100 person years） in Guangxi. Conclusion Other than regular routine HIV antibody testing, it seemed necessary to adopt the HIV RNA pooling strategy in high-risk groups such as FSWs, so as to early detect the HIV infection and to timely perform the intervention or treatment programs to prevent sexual transmission of HIV.

关 键 词：HIV急性感染 集合核酸检测 女性性工作者 发病率 

分 类 号：R512.91[医药卫生—内科学]