无偿献血者HIV初筛检测策略及确证结果对比分析  

Comparative Analysis of HIV Screening Test Strategy and Confirmatory Results in Voluntary Blood Donors

作　　者：谭畅[1] 申俊锋 唐飞[1] 陈文霞[1] 张玉敏[1] TANChang;SHEN Jun-feng;TANG Fei(Guizhou Blood Center,Guiyang 55000)

机构地区：[1]贵州省血液中心,贵阳550002

出　　处：《临床输血与检验》2018年第6期566-568,614,共4页Journal of Clinical Transfusion and Laboratory Medicine

摘　　要：目的采用酶联免疫检测(ELISA)和核酸检测(NAT)并行的模式,同时结合蛋白免疫印迹(WB)试验结果,全面评估酶联免疫检测和核酸检测在降低输血相关感染风险中的相关性。方法统计2015年5月～2016年7月281例ELISA呈反应性标本,分析2种ELISA初筛试剂、NAT及WB检测结果。结果①ELISA初筛试验:281例标本中S/CO≥1的万泰试剂110例,伯乐试剂156例;S/CO值0.75～1.0中万泰试剂20例,伯乐试剂39例;②WB检测结果:阳性27例,不确定12例,阴性242例。初筛检测S/CO值在0.75～1.0的所有标本,经WB检测没有阳性结果;③NAT检测结果:49例核酸阳性,232例核酸阴性。结论两种ELISA初筛试剂检测标本反应率不同,差异有统计学意义;ELISA方法的检测结果处于强反应性水平时,NAT及WB检测结果符合率较高,ELISA弱反应性标本中2种方法的符合率较低,减掉1遍ELISA对检测试剂和人员均提出了更高的要求。献血前的招募、征询工作应加强,确保从低危人群中招募献血者,确保临床用血安全。Objective To discuss the comprehensive evaluation of the correlation between Enzyme-linkedimmunosorbent assay （ELISA）and nucleic acid test （NAT）in decreasing the risk of transfusion-associated infectionwas carried out via the detection model of ELISA in parallel with NAT,which in turn was combined with the results fromconfirmatory assays. Methods Positive samples from screening assays between May 2015 to July 2016 were analyzed interms of the S/CO values of two kinds of ELISA reagents as well as results of both NAT and Western blotting,the latter beingconfirmatory. Results The results of all 281 tested samples were as followed,in primary screening test：110 cases of Wantaireagent with S/CO≥1 and 156 cases of BIO-RAD reagent; 20 cases of Wantai reagent with 0.75〈S/CO〈1,39 cases fromBIO-RAD reagent. HIV confiormatoryive WB test：27 were positive and 242 were negative,49 cases could not be determinedby this method. NAT test：49 were positive and 232 were negative. Conclusion The reaction rate of two kinds of ELISAscreening reagents was different,the difference was statistically significant. Results showing strong reactivity in ELISAhad higher consistency with NAT whilst low ELISA reactivity samples delivered lower consistency with NAT and Westernblotting. Besides,conducting ELISA for one less time leads to higher requirements on both reagents and operating personnel.At the same time,we should strengthen recruitment and promotion,strengthening publicity of high-risk sexual behaviorpeople voluntarily gave up blood donation of medical purposes,established fixed blood donor of blood donor recruitment ismore conducive to blood safety.

关 键 词：HIV 酶联免疫检测 蛋白免疫印迹试验 核酸检测 

分 类 号：R373[医药卫生—病原生物学] R446.11[医药卫生—基础医学]