深圳141例HIV抗体不确定检测结果分析  

Analysis of uncertainty test results of 141 cases of HIV antibody in Shenzhen

作　　者：甘永霞[1] 杨峥嵘[1] 李浩[1] 黎桂连[1] 石向东[1] 刘少础[1] 王晓辉[1] 赵锦[1] GAN Yongxia;YANG Zhengrong;LI Hao;LI Guilian;SHI Xiangdong;LIU Shaochu;WANG Xiaohui;ZHAO Ji(Shenzhen Center for Disease Control and Prevention,Shenzhen,Guangdong,China,518055)

机构地区：[1]深圳市疾病预防控制中心,广东深圳518055

出　　处：《分子诊断与治疗杂志》2021年第5期715-719,共5页Journal of Molecular Diagnostics and Therapy

基　　金：广东省医学科学技术研究基金项目(A2019474);深圳市科技计划项目(JCYJ20140410171018515,JCYJ20150402102135492);深圳市引进高层次医学团队项目“三名工程”(SZSM201811071);深圳市卫生系统科研项目(SZGW2018003)。

摘　　要：目的对141例HIV抗体不确定样本的结果进行分析,为开展HIV确证检测提供准确有效的判定依据。方法采用WB法对2017至2019年深圳辖区内各筛查实验室送检的HIV抗体筛查有反应的样本进行确证试验,141例被确证为不确定结果的样本结合CD4^(+)T淋巴细胞检测结果进行综合分析。结果141例不确定样本中,p24条带出现的占比最高,为77.3%,其次是gp160条带,为32.6%。总随访率为22.7%,在失访的109例受检者中,血站占37.6%(41例),医疗机构占45.0%(49例)。在随访到的32例受检者中有11例阳转,11例阳转前后的CD4^(+)T淋巴细胞绝对数和CD4^(+)/CD8^(+)细胞比值比较,差异无统计学意义(P>0.05)。21例条带未进展受检者前后的CD4^(+)T淋巴细胞绝对数比较,差异无统计学意义(P>0.05),其CD4^(+)/CD8^(+)细胞比值比较,差异有统计学意义(P<0.05)。11例转阳者与21例条带未进展者的第一带型和第一带型,第二带型和第二带型的CD4^(+)T淋巴细胞绝对数及其CD4^(+)/CD8^(+)细胞比值分别比较,差异有统计学意义(P<0.05)。结论深圳应重视加强医疗机构和血站的HIV首次不确定受检者的后续随访跟踪工作,紧密结合实验室的相关检测结果尽早做出判断,避免延迟HIV感染的诊断而引起二代传播的风险。Objective To analyze the results of 141 cases of HIV antibody from indeterminate samples and provide an accurate and effective basis for the implementation of HIV confirmation testing.Methods Western blot analysis was used to confirm the HIV antibody screening response samples submitted by various screening laboratories in Shenzhen from 2017 to 2019.141 samples confirmed as uncertain results were comprehensively analyzed combined with CD4^(+)T lymphocyte test results.Results Among the 141 uncertain samples,the p24 band appeared in the highest proportion at 77.3%,followed by the gp160 band at 32.6%.The total follow-up rate was 22.7%,among the 109 cases lost to follow-up,blood stations accounted for 37.6%(41 cases)and medical institutions accounted for 45.0%(49 cases).Among the 32 cases,there were 11 cases of positive conversion.The absolute number of CD4^(+)T lymphocytes and the ratio of CD4^(+)/CD8^(+)cells in 11 cases before and after positive conversion showed no significant difference(P>0.05).There was no significant difference in the absolute number of CD4^(+)T lymphocytes before and after the test in 21 cases of unprogressive bands(P>0.05),and the difference in the ratio of CD4^(+)/CD8^(+)cells was statistically significant(P<0.05).The absolute number of CD4^(+)T lymphocytes and the ratio of CD4^(+)/CD8^(+)cells in the first band type,the first band type,the second band type and the second band type were significantly different between 11 positive cases and 21 unprogressive cases(P<0.05).Conclusion Shenzhen should pay attention to strengthening the follow-up follow-up work of medical institutions and blood stations for HIV-indeterminate subjects for the first time,and make judgments as soon as possible in close conjunction with the relevant laboratory test results to avoid the risk of delaying the diagnosis of HIV infection and causing the risk of second-generation transmission.

关 键 词：HIV 抗体不确定 阳转 WB带型 CD4^(+)T淋巴细胞 

分 类 号：R512.91[医药卫生—内科学] R446.6[医药卫生—临床医学]