HIV-1 RNA定量检测在HIV感染诊断中的应用  

Application of HIV-1 RNA quantitative testing in diagnosis and analysis of HIV infections

作　　者：雷达 张娜[1] 吴争[1] 靳廷丽[1] 唐翼龙[1] 丁晨[1] 刘家虹[1] LEI Da;ZHANG Na;WU Zheng;JIN Tingli;TANG Yilong;DING Chen;LIU Jiahong(Jiangxi Provincial Center for Disease Control and Prevention,Nanchang 330001,China)

机构地区：[1]江西省疾病预防控制中心,南昌330001

出　　处：《中国艾滋病性病》2022年第8期939-942,共4页Chinese Journal of Aids & STD

基　　金：江西省卫生健康委科技计划。

摘　　要：目的通过采用HIV-1 RNA定量检测,对HIV筛查试验有反应但WB结果为阴性或不确定的样本进行诊断分析,探讨HIV-1 RNA定量检测在实际HIV感染诊断临床验证工作中的应用。方法回顾性地对2020年江西省确证实验室收集的172例WB阴性和138例WB不确定的样本进行HIV-1 RNA定量检测,以HIV-1 RNA定量结果>5000拷贝/mL为HIV感染诊断标准,将核酸诊断结果与病例追踪复检的WB确证结果进行比较分析。结果WB阴性的样本有4.65%(8/172)检出HIV-1 RNA阳性,WB不确定的样本有64.49%(89/138)检出HIV-1 RNA阳性。其中96例(8例WB阴性、88例WB不确定)样本HIV-1 RNA定量结果>5000拷贝/mL,另有1例WB不确定样本HIV-1RNA定量结果在20~5000拷贝/mL之间,该97例样本随访的WB结果均为阳性;HIV-1 RNA定量结果低于检出限者213例(164例阴性、49例不确定),随访WB结果均为阴性。以5000拷贝/mL为阳性诊断阈值,本研究中HIV-1 RNA定量检测应用于HIV感染诊断的敏感性为98.97%(96/97),特异性为100.00%(213/213)。结论HIV-1 RNA定量检测用于HIV感染诊断,能减少WB不确定病例的追踪随访,同时避免WB阴性病例的漏检,实现HIV感染者的快速有效诊断,并使其尽早开始艾滋病抗病毒治疗。Objective To diagnose HIV infections with indeterminate or negative HIV western blot(WB)results by HIV-1 RNA quantitative testing.Methods 172 specimens with negative results and 138 specimens with indeterminate results by WB in Jiangxi Province,2020,were examined by HIV-1 RNA quantitative testing.Viral loads>5000 copies/mL were used as the diagnostic criteria.Results 4.65%(8/172)of negative WB samples and 64.49%(89/138)of indeterminate WB samples were identified as positive in HIV-1 RNA quantitative testing.There were 8 negative WB samples and 88 indeterminate WB samples which HIV-1 RNA viral loads were more than 5000 copies/mL,and only 1 indeterminate WB sample’s HIV-1 RNA viral loads were between 20-5000 copies/mL.All the 97 samples were positive by the follow-up retest of WB after 4-12 weeks.Meanwhile,213 samples with viral loads of the undetected target were negative by the follow-up WB testing.When the positive diagnostic threshold was set as 5000 copies/mL,the sensitivity and specificity of HIV-1 RNA quantitative testing in HIV diagnosis were 98.97%(96/97)and 100%(213/213).Conclusions HIV-1 RNA quantitative testing can identify the samples with negative and indeterminate results.As a result,the follow-up WB testings of indeterminate cases were reduced,avoiding missing detection of negative cases.HIV-1 RNA quantitative testing can diagnose HIV infections quickly and efficiently and promoting early AIDS antiviral treatment.

关 键 词：艾滋病病毒 核糖核酸定量检测 蛋白印迹试验 

分 类 号：R512.91[医药卫生—内科学] R373.9[医药卫生—临床医学]