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目的分析人免疫缺陷病毒(HIV)抗体筛查阳性标本确认试验的临床意义。方法对2013年5月至2016年6月乌鲁木齐某一HIV监测哨点使用酶联免疫吸附试验(ELISA)初筛阳性的标本进行免疫蛋白印迹试验(Western Blotting,WB)确认。结果初筛HIV抗体阳性的435份标本中,经WB法进行确认试验,HIV抗体阳性为347份(81.6%),HIV抗体阴性为31份(7.3%),HIV抗体不确定为57份(13.4%),且阳性的带型gp160、gp120、p66、p51、gp41、p31、p24出现的百分率都在90%以上,其中gp160、gp120、p24为100%,p55出现次数最少,仅为62.8%。在347例HIV确定感染者中,阳性率最高的为包膜蛋白(envelope protein,env)条带,平均达到99.6%;其次是多聚酶蛋白(polymerase protein,pol)条带,平均为94.5%;阳性率最低的是核心蛋白(gag)条带,平均为82.3%。在不确定的57份标本中,阳性率最高的为gag条带,平均为58.8%,其中p24条带出现频率最高,为80.7%(46/57);其次是pol条带,平均为28.1%;阳性率最低的是env条带,平均为12.3%。结论 HIV抗体初筛试验容易出现假阳性,只有进行确认试验才能得出准确结果,并且需进一步加强实验室质量管理,避免引起初筛试验假阳性的因素,为AIDS的预防控制工作提供及时准确的科学参考。
Objective To analyze the clinical significance of confirming the test by positive samples of human immunodeficiency virus (HIV) antibody screening. Methods From May 2013 to June 2016, positive samples were screened by ELISA using Western Blotting (WB) from an HIV surveillance sentinel station in Urumqi. Results Among the 435 positive HIV antibody positive specimens, 347 (81.6%) were HIV positive, 31 (7.3%) were negative for HIV antibody and 57 were HIV antibody indeterminate (13.4 %). The percentages of positive gp160, gp120, p66, p51, gp41, p31 and p24 were more than 90%, of which gp160, gp120 and p24 were 100%, and p55 was the least, only 62.8%. Among the 347 HIV-positive patients, the envelope protein (env) band with the highest positive rate was 99.6%, followed by a polymerase protein (pol) band with an average of 94.5% The lowest was the gag band, averaging 82.3%. Among 57 uncertain samples, the highest positive rate was gag band, with an average of 58.8%. Among them, the highest frequency of p24 bands was 80.7% (46/57), followed by pol bands with an average of 28.1% ; The lowest positive rate was env band, with an average of 12.3%. Conclusion HIV antibody screening test is prone to false positive, only confirm the test to get accurate results, and need to further strengthen the laboratory quality management, to avoid the false positive factor of primary screening test, to provide timely and accurate AIDS prevention and control work Scientific reference.