北海市2016年-2017年HIV抗体蛋白免疫印迹试验不确定结果分析  

Analysis of uncertain results for immunoblotting test of HIV antibody protein from 2016 to 2017 in Beihai City

作　　者：朱豪[1] 杨国然[1] 白海涛[1] 李师勤[1] 韩沪影 陈小玲 ZHU Hao;YANG Guo-ran;BAI Hai-tao;LI Shi-qin;HAN Hu-ying;CHEN Xiao-ling(Beihai Municipal Center for Disease Control and Prevention,Beihai,Guangxi 536000,China)

机构地区：[1]北海市疾病预防控制中心,广西北海536000

出　　处：《中国卫生检验杂志》2020年第7期813-816,共4页Chinese Journal of Health Laboratory Technology

摘　　要：目的通过蛋白免疫印迹试验中艾滋病病毒(HIV)抗体不确定带型的特征,分析产生不确定结果的血清学特点及追踪随访结果,为尽早明确诊断提供科学依据。方法回顾性分析北海市2016年-2017年确证实验中出现的HIV抗体不确定结果资料,结合流行病学随访、CD4+T淋巴细胞计数和病毒载量,分析不确定人群带型进展、转归和蛋白免疫印迹试验带型分布特点。结果64例不确定样本中,来源于医疗机构就诊者占40.6%(26例);自愿咨询检测者占29.69%(19例),无偿献血者占15.6%(10例),公安司法占10.9%(7例),哨点监测占3.1%(2例)。不确定样本共有12种带型,env类、gag类和pol类带型分别占23.44%、71.88%、4.69%。单一带型中,P24带型占的比例最高。完成随访的37例样本中,env类条带的阳转率为13.5%(5/37),pol类、gag类带型未发现阳转。结论gag类不确定最为常见,非特异性反应居多;env类带型的不确定结果阳转率较高,感染HIV的可能性更大;严格进行实验环节质量控制;谨慎对待不确定结果,结合其他辅助方法综合判断,提高检测准确率;对不确定结果的患者应加强随访,避免不确定样本流失。Objective To analyze the characteristics of uncertain results for immunoblotting test of HIV antibody protein and serological characteristics of uncertain outcomes and follow-up results,providing scientific basis for early and definite diagnosis.Methods Retrospective analysis was made on the uncertain results of HIV antibodies in confirmed tests in Beihai City from 2016 to 2017,combining with epidemiological follow-up,CD4+T lymphocyte count and viral load.To analyze the progress and outcome of banding patterns in uncertain population and the distribution characteristics of banding patterns in protein immunoblotting test(WB).Results In 64 uncertain samples,40.6%came from medical institutions,29.69%came from voluntary counseling and testing,15.6%came from voluntary blood donors,10.9%came from public security judiciary,3.1%came from sentinel surveillance.There are 12 bands in the uncertain samples,env,gag and pol bands accounted for 23.44%,71.88%and 4.69%.P24 band type accounts for the highest proportion in single band type.The positive conversion rate of env bands was 13.5%,and positive gag bands and pol bands were not observed.Conclusion Uncertainty of gag class is the most common,nonspecific reactions were in the majority.The positive conversion rate of uncertain results of env band type is higher,HIV infection is more likely.Strict quality control of experimental links,being cautious about uncertain results,combining with other auxiliary methods,improving the detection accuracy,uncertain results patients should be followed up to avoid loss of uncertain samples.

关 键 词：蛋白免疫印迹试验 艾滋病病毒抗体 不确定结果 追踪随访 

分 类 号：R446.6[医药卫生—诊断学]