3例急性期HIV-1感染病例实验室检测及病毒亚型分析  

Laboratory testing and virus genotyping of three acute HIV-1 infection cases

作　　者：李佳[1] 张京姬[2] 叶江竹[2] 代漫 辛若雷[1] 张琴[1] 李砚萍[1] 庞灿 邓煜川 李洁[1] 黄春[1] 卢红艳[1] Li Jia;Zhang Jingji;Ye Jiangzhu;Dai Man;Xin Ruolei;Zhang Qin;Li Yanping;Pang Can;Deng Yuchuan;Li Jie;Huang Chun;Lu Hongyan(Institute for STD/AIDS Prevention and Treatment,Beijing Center for Disease Prevention and Control,Beijing 100013,China;Center for STD/AIDS Diagnosis and Treatment Center,Beijing You An Hospital,Capital Medical University,Beijing 100069,China;School of Public Health,China Medical University,Shenyang 110122,China)

机构地区：[1]北京市疾病预防控制中心性病艾滋病防治所,100013 [2]首都医科大学附属北京佑安医院性病艾滋病诊疗中心,100069 [3]中国医科大学公共卫生学院,沈阳110122

出　　处：《国际病毒学杂志》2023年第1期71-74,共4页International Journal of Virology

基　　金：北京市自然科学基金(7202074);首都卫生发展科研专项(首发2022-1G-3015)。

摘　　要：目的对艾滋病筛查有反应而确证试验阴性或不确定病例进行随访和HIV-1核酸检测,分析感染毒株基因亚型。方法对3个艾滋病筛查有反应且免疫印迹试验(western blot,WB)阴性或不确定病例进行HIV-1核酸检测和随访。采用一步法RT-PCR扩增HIV-1 pol基因片段,构建系统进化树分析其基因亚型。结果3个HIV抗体筛查有反应病例,经WB检测病例1和3出现p24条、病例2未检测到特异条带。pol基因片段系统进化分析显示病例1和3均感染CRF07_BC毒株,病例2感染CRF01_AE毒株(第5簇)。对病例1和3进行2周后随访检测,WB条带有进展,HIV-1病毒载量分别为476385 cp/mL和103462 cp/mL,CD4^(+)T淋巴细胞计数分别为220个/µl和550个/µl。结论急性期HIV-1感染表现为筛查有反应而WB阴性或不确定,HIV-1核酸检测有助于提高急性期感染的发现和诊断能力。Objective To conduct follow-up and nucleic acid test for individuals with negative or indeterminate HIV confirmatory results,and to analyze the genotypic subtyping.Methods Follow-up tests and nucleic acid tests were carried out for three cases with screening reactive and negative or indeterminate Western Blot(WB)results.Pol gene fragment was amplified by one-step reverse transcriptase polymerase chain reaction,and phylogenetic tree was constructed to analyze its genotype.Results Three cases were reactive for first HIV screening,and cases 1 and 3 were detected with p24 band and case 2 was negative without specific band.The genotypic analysis by HIV-1 pol gene indicated that cases 1 and 3 got infected by CRF07_BC,and case 2 by CRF01_AE(cluster 5).Cases 1 and 3 were followed up 2 weeks later,with evolving WB bands.The viral loads for the two cases were 476385 cp/ml and 103462 cp/ml,and the CD4^(+)T lymphocyte counts were 220/µl and 550/µl,respectively.Conclusions Acute HIV-1 infection may express reactive screening with negative or indeterminate WB results.

关 键 词：艾滋病病毒 急性期HIV-1感染 病毒载量 免疫印迹试验 

分 类 号：R512.91[医药卫生—内科学]