737例HIV抗体重组免疫印记的不确定情况分析  

An analysis of 737 people with HIV-indeterminate results by recombinant immunoblot assay

作　　者：李姗珊 朱丹 高钰双 郭悦 张燕琳[1] 龚芳红[1] 朱昆蓉[1] LI Shan-shan;ZHU Dan;GAO Yu-shuang;GUO Yue;ZHANG Yan-lin;GONG Fang-hong;ZHU Kun-rong(Chengdu Center for Disease and Control Prerention,Chengdu,Sichuan 610041,China)

机构地区：[1]成都市疾病预防控制中心,四川610041

出　　处：《现代预防医学》2020年第23期4340-4343,4399,共5页Modern Preventive Medicine

摘　　要：目的了解重组免疫印迹(RIBA)确证人免疫缺陷病毒(HIV)抗体的不确定情况,探索转归规律,为实验室检测和艾滋病防治提供参考依据。方法回顾性分析2018年成都地区采用RIBA确证HIV抗体为不确定的人群特征和条带特征,追踪不确定者的抗体复查结果和时间。结果共有737名抗体不确定者,占检测人数的10.87%。女性不确定比例高于男性。各类送检来源中,孕产妇的不确定比例(44.05%)最高。抗体不确定带型共有15种,以gp160(46.68%)、gp160和gp41(21.44%)、p24(16.01%)为主。170名(23.07%)不确定者进行了抗体复查,65人转阳,18人转阴,87人不确定。老年人的转阳率较高,≥70岁可达94.12%(X^2=42.941,P<0.001)。gp160、gp41带型转阳率(84.75%)较高(X^2=74.132,P<0.001),p24转阴率(31.58%)较高(X^2=13.782,P=0.001)。转阳者和复查不确定者的复查间隔时间分布差异有统计意义(H=7.270,P=0.026)。结论女性通过RIBA检测HIV抗体的不确定比例高于男性。RIBA确证HIV抗体的不确定带型主要是gp160、gp160和gp41、p24。在有限条件下可优先加强高转阳率带型(gp160和gp41)及高转阳率人群(老年人)随访。Objective To study the indeterminate of recombinant immunoblot assay(RIBA)confirming HIV antibody,and toexplore the law of indeterminate outcome,and to provide relevant evidence for improving laboratory diagnosis and AIDS prevention.Methods A retrospective analysis of the population characteristics and banding characteristics of HIV-indeterminate which were confirmed by RIBA in 2018 in Chengdu was conducted,and the results and time of antibody re-examination were tracked.Results A total of 737 people got indeterminate results,accounting for 10.87%of the people tested.Women are more likely to be indeterminate than men.The highest proportion of indeterminate results was observed in pregnant women(44.05%).15 HIV-indeterminate band patterns were detected by RIBA,mainly gp160(46.68%),gp160 and gp41(21.44%),and p24(16.01%).170(23.07%)of HIV-indeterminate people returned for re-examination,of which 65 were converted to positive,79 were converted to negative,and 80 were still indeterminate.The elderly have a higher positive conversion rate,reaching 94.12%when they are over 70(X^2=42.941,P<0.001).Gp160 and gp41 band pattern had the higher positive conversion rate(84.75%)(X^2=74.132,P<0.001),and p24 negative conversion rate(31.58%)(X^2=13.782,P=0.001)was relatively high.There is a significant difference in the distribution of re-examination intervals between those who have turned positive and those who are indeterminate(H=7.270,P=0.026).Conclusion Women are more likely than men to have HIV-indeterminate by RIBA.HIV-determinate band patterns by RIBA are mainly gp160,gp160,gp41,and p24.Under limited conditions,Priority can be given to high conversion rate bands(gp160 and gp41)and high conversion rate groups(the elderly)when follow-up conditions are limited.

关 键 词：人免疫缺陷病毒 重组免疫印迹 抗体不确定 转归 

分 类 号：R115[医药卫生—公共卫生与预防医学] R512.91