1例易漏检HIV-1早期感染病例分析  

Analysis of One Case of HIV-1 Infection Who was Easy Missed for Detection

作　　者：张英[1] 肖丽 江超 何晓冬[1] ZHANG Ying;XIAO Li;JIANG CHao;He Xiaodong(Zigong Center for Disease Control and Prevention,Zigong 643000,Sichuan Province,China;Gongjing District Center for Disease Control and Prevention,Zigong 643020,Sichuan Province,China)

机构地区：[1]自贡市疾病预防控制中心,四川自贡643000 [2]自贡市贡井区疾病预防控制中心,四川自贡643020

出　　处：《寄生虫病与感染性疾病》2020年第4期238-241,共4页Parasitoses and Infectious Diseases

摘　　要：目的分析1例HIV-1感染病例初筛确证及核酸检测结果,为临床医生采取合理的治疗方案提供辅助诊断依据。方法选取1例HIV-1抗体初筛有反应,确证(WB)试验无带,核酸阳性的样本进行跟踪随访调查,结合流行病学史对该病例确定其感染状况。结果该病例第一次检测结果用初筛检测方法均为有反应性,确证检测方法均为无带,核酸结果21779220 CPs/ml,第2次23 d后随访结果,初筛试验均为有反应性,确证结果转阳,核酸减少100倍(213270 CPs/ml),CD4结果109个/μl。结论仅依据抗体确证检测结果出具HIV抗体阴性报告,有可能造成漏检。应将核酸检测方法和流行病学史结合,以便及时发现早期感染者,从而实现早发现、早诊断、早治疗的目标,有效预防和控制艾滋病的传播。Objective To analyze the results of primary screening,confirmation and nucleic acid test of 1 HIV-1 case so as to provide an auxiliary diagnostic basis for clinicians to adopt a reasonable treatment plan.Methods One case of HIV-1 antibody with initial screening response,Western blots tests without band and nucleic acid positive sample was selected for follow-up,and its infection status was determined based on the epidemiological history.Results The first test results of this case were all reactive by the primary screening,but all the confirmed tests were strainless.The results of nucleic acid tests were 21779220 CPs/ml.After the second 23 days follow-up,the first test results were all reactive,the confirmed tests were positive,the nucleic acid decreased by 100 times(213270 CPs/ml),and the CD4 results were 109/ul.Conclusion The negative HIV antibody report justly based on the antibody confirmation test may cause missed detection.The nucleic acid detection method and the epidemiological history should be combined in order to timely detect the early infection,achieve the goal of early detection,early diagnosis,early treatment,effective prevention and control of the spread of AIDS.

关 键 词：HIV-1抗体 核酸检测 早期HIV感染者 

分 类 号：R446[医药卫生—诊断学] R512.91[医药卫生—临床医学]