人类免疫缺陷病毒实验室诊断策略的实施与质量控制  

Implementation and quality control of human immunodeficiency virus laboratory diagnosis strategy

作　　者：王远芳[1] 李冬冬[1] 谢轶[1] Wang Yuanfang;Li Dongdong;Xie Yi(Department of Laboratory Medicine,Westchina Hospital of Sichuan University,Chengdu 610041,China)

机构地区：[1]四川大学华西医院实验医学科微生物实验室,成都610041

出　　处：《中华预防医学杂志》2023年第1期1-7,共7页Chinese Journal of Preventive Medicine

摘　　要：人类免疫缺陷病毒(human immunodeficiency virus,HIV)的实验室诊断策略是通过组合现有HIV检测方法,准确检出HIV患者的流程。HIV感染的实验室检测方法主要包括血清学抗体、抗原检测和HIV-1 RNA检测。随着检测试剂更新换代,HIV检测的灵敏度和特异度有大幅度提高,检测窗口期缩短,但存在假阳性的风险。针对不同目的人群和不同流行率地区,各类指南推荐了不同的诊断策略,引导患者尽早确诊并接受规范的抗逆转录病毒治疗。如何参照诊断策略,在提高检出率的同时降低假阳性、缩短窗口期,是实验室亟待解决的问题。本研究从实验室诊断策略的角度,阐述了HIV感染相关检测方法的特点和优劣势,以及治疗手段的发展对诊断策略的影响,以期为HIV诊断策略的实际应用提供理论支撑。The laboratory diagnostic strategy for human immunodeficiency virus(HIV)is a process to accurately detect HIV patients through a combination of available HIV tests.Laboratory tests for HIV infection are mainly serological antibody and antigen testing and HIV RNA testing.With the update of testing reagents,the sensitivity and specificity have improved substantially and the window period of detection has shortened,but there is a risk of false positives.Various guidelines have recommended different diagnostic strategies for different target populations and different prevalence regions to guide patients to confirm the diagnosis and receive standardized antiretroviral therapy as early as possible.How to refer to the diagnostic strategies,reduce false positives and shorten the window period while increasing the detection rate is an urgent issue for laboratories to address.This article describes the characteristics and advantages and disadvantages of testing methods related to HIV infection from the perspective of laboratory diagnostic strategies,as well as the impact of the development of treatments on diagnostic strategies,in order to provide theoretical support for the practical application of HIV diagnostic strategies.

关 键 词：人类免疫缺陷病毒 实验室检测 诊断策略 

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