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目的了解湖南省长沙市和常德市男男性接触者(men who have sex with men,MSM)早期感染人类免疫缺陷病毒(HIV)-1的情况,估算新发感染率,并评价不同检测方法的使用情况。方法在长沙市和常德市各类MSM活动现场,匿名收集承认半年内与其他男性发生过性行为(肛交)、自愿参与本调查的成年男性EDTA抗凝血10ml,送实验室进行HIV血清学及核酸检测。结果 1 349名调查对象中,使用三代双抗原夹心ELISA法检出阳性169例,阳性率12.53%;四代ELISA法检出阳性173例(包含三代初筛阳性的169例),经Western blot确证阳性156例,不确定12例,阴性5例,确证阳性率11.56%。1 193份初筛阴性及确证血清抗体阴性或不确定样本中,使用四代ELISA法检出阳性17例,阳性率1.42%;同时使用核酸扩增法(NAAT)检出阳性18例,阳性率1.51%。结论 MSM人群中HIV-1急性期感染现象值得关注,开展高危行为心理分析和干预非常有必要。在筛选急性感染病例时,四代ELISA特异性高且较为敏感,值得推广。
Objective To understand the early infection status of human immunodeficiency virus (HIV) -1 among men who have sex with men (MSM) in Changsha and Changde of Hunan Province, evaluate the new infection rate and evaluate the use of different detection methods Happening. Methods In the MSM activities in Changsha City and Changde City, we collected 10ml of anticoagulant EDTA from adults who had sex with other men within 6 months and who volunteered to take part in this investigation. Nucleic acid test. Results A total of 1 349 subjects were detected by sandwich ELISA. The positive rate was 12.53%. The positive results of four generations of ELISA were 173 (including 169 positive for three generations of primary screening) Positive 156 cases, 12 cases of indeterminate, negative in 5 cases, confirmed positive rate of 11.56%. Among 193 positive and negative serological samples, 1 positive and 17 positive were detected by the four-generation ELISA, the positive rate was 1.42%. The positive rate was also detected by NAAT, the positive rate 1.51%. Conclusions The acute phase infection of HIV-1 in MSM population deserves our attention. It is necessary to carry out high-risk behavioral psychological analysis and intervention. In the screening of acute cases of infection, the fourth generation of ELISA is highly specific and sensitive and is worth promoting.