核酸检测在艾滋病晚期患者诊断中的应用  

The application of nucleic acid test in the diagnosis of late-stage AIDS

作　　者：陈会超[1] 苏莹珍[1] 陈敏[1] 杨莉[1] 杨朝军[1] 施玉华[1] 彭正珍 李云德[3] 闫文云[1] 陈玲[1] 董莉娟[1] 马艳玲[1] 

机构地区：[1]云南省疾病预防控制中心,云南昆明650022 [2]文山州疾病预防控制中心,云南文山663000 [3]普洱市疾病预防控制中心,云南普洱665000

出　　处：《现代预防医学》2014年第16期3025-3026,3029,共3页Modern Preventive Medicine

摘　　要：目的探讨核酸检测在艾滋病晚期患者诊断中的意义和实际应用价值。方法对2011-2012年常规HIV抗体确证实验中结果为不确定的5例样本,用核酸检测进行HIV感染的诊断。结果5例样本经HIV抗体筛查试验均为阳性,2份样本HIV抗体确证试验出现gp41,gp120,gp160 3条env带,3份样本出现gp120,gp160 2条env带,根据检测技术规范结果判为不确定,经随访检测部分样本带型无进展。根据HIV核酸检测,5例样本HIV RNA检测均为阳性,结合CD4细胞计数和流行病学资料,最终判定受检者HIV感染。结论随着艾滋病流行时间的延长,艾滋病晚期病例不断增多,实际工作中仅依靠抗体检测进行诊断的难度加大。因此,可综合利用多种HIV检测方法,尤其是核酸检测方法并结合流行病学资料,及时对病人进行诊断。Objective The objective of the study was to explore the significance and practical application value of nucleic acid test in the diagnosis of late-stage AIDS. Methods 5 suspected samples unconfirmable by routine HIV antibody test performed during 2011-2012 were subjected to nucleic acid test for the diagnosis of HIV infection. Results The 5 samples were tested positive by HIV antibody screening, from which 2 of the samples exhibited 3 env bands （gp41, gpl20, and gp160） and the others showed 2 env bands （gp120 and gp160）. The results were considered unconfirmable according to standard test protocols, and band patterns of some of the samples were tested non-progressing in follow-up tests. Using HIV nucleic acid test, the 5 samples were tested HIV RNA-positive; the result was then considered together with CD4 cell counts and epidemiological data to confirm that the 5 cases were indeed infected with HIV. Conclusion As AIDS epidemic continues to grow, cases of late-stage AIDS have been rising and diagnosis based solely on antibody test has become increasingly difficult. Therefore, combining multiple HIV test methods, especially nucleic acid test and epidemiology data, should be adopted to timely diagnose patients with late-stage AIDS.

关 键 词：核酸检测 艾滋病晚期 诊断 

分 类 号：R446[医药卫生—诊断学]