HIV新近感染的检测技术现状及其在艾滋病防控中的作用  

State-of-the-art of technologies to identify recent HIV infection and its role in controlling AIDS epidemic

作　　者：崔明婷 李顺然 王浩航 袁建辉 周毅[3] 孙彩军 Cui Mingting;Li Shunran;Wang Haohang;Yuan Jianhui;Zhou Yi;Sun Caijun(School of Public Health(Shenzhen),Sun Yat-sen University,Shenzhen 518107,China;Nanshan District Center for Disease Control and Prevention,Shenzhen 518054,China;Department of HIV Prevention,Zhuhai Center for Disease Control and Prevention,Zhuhai 519060,China;Key Laboratory of Tropical Disease Control(Sun Yat-sen University),Ministry of Education,Guangzhou 510030,China)

机构地区：[1]中山大学公共卫生学院(深圳),深圳518107 [2]深圳市南山区疾病预防控制中心,深圳518054 [3]珠海市疾病预防控制中心艾滋病防制所,珠海519060 [4]中山大学热带病防治研究教育部重点实验室,广州510030

出　　处：《中华实验和临床病毒学杂志》2024年第2期193-201,共9页Chinese Journal of Experimental and Clinical Virology

基　　金：国家自然科学基金(82271786);深圳市南山区引进高层次(三名)医学团队项目(SZSM202103008);深圳市科技计划项目(JCYJ20190807155009482);深圳市南山区艾滋病监测与防控重点学科资助项目。

摘　　要：目前,艾滋病监测主要通过哨点监测和艾滋病病例报告系统来计算人类免疫缺陷病毒(human immunodeficiency virus,HIV)感染率、艾滋病新报告病例数和HIV相关死亡率,以及开展全国性研究调查HIV耐药毒株特征,但这些措施不能估算HIV新近感染率。HIV感染的病程隐蔽且具有长期潜伏感染的特性,急性期感染者难以被发现,常规监测手段难以确定感染者的感染时间,从而使得新近感染率的计算存在潜在偏倚,影响对疾病危险因素的深入探究以及评价干预措施的效果。近年来,使用HIV-1新近感染检测(test for recent infection,TRI)基于横断面样本估算HIV新近感染率已成为监测HIV传播、评估干预手段的重要方法之一,其可以将HIV-1感染者分为新近感染与长期感染,提高HIV新近感染率测量的准确性。TRI分为血清学检测与分子检测,其中血清学检测因其成本低、估算HIV新近感染率准确、发展历史较长而被广泛使用,近年来在准确度与简便性方面取得较大进展。本文通过对TRI的原理、准确度以及应用的介绍,系统综述TRI技术的最新研究进展及优缺点。Currently,human immunodeficiency virus(HIV)surveillance mainly relies on sentinel surveillance and the HIV/acquired immunodeficiency syndrome(AIDS)case reporting system to calculate the HIV infection rate,the number of newly reported HIV cases,and the HIV-related mortality rate,while theses measures are not able to directly estimate the HIV incidence.National-level research is conducted to investigate the characteristics of drug-resistant strains of HIV.HIV infection has the characteristics of a covert progression and a long-term latent phase,making it difficult to identify individuals in the acute infection stage.Conventional monitoring method struggles to determine the infection time of individuals,thereby introducing potential biases in the estimation of the incidence and impacting the comprehensive exploration of disease risk factors and the assessment of intervention measures.Recently,test for recent infection(TRI),as one of AIDS epidemic surveillance and intervention assessment measures,has become a vital way to estimate HIV incidence by testing the cross-sectional specimens.TRI can identify recent HIV infection and long-term HIV infection,consisting of serological and molecular method.Serological assays have been widely used because of their low cost,high accuracy of HIV infection incidence estimate and long development history,and their accuracy and simplicity have achieved significant progress in recent years.According to introduct the principle,accuracy and application of TRI,this paper reviews the latest progress,advantages,and limitations of TRI.

关 键 词：艾滋病 人类免疫缺陷病毒 新近感染 新近感染检测 

分 类 号：R512.91[医药卫生—内科学]