Pooling PCR技术用于发现病程早期HIV感染者的研究
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摘要
目的研究探讨Pooling PCR技术诊断识别病程早期(急性感染期)艾滋病病毒感染者的能力,并评估该方法是否经济可行、是否可以在部分人群的艾滋病病毒感染状态的诊断中取代艾滋病抗体检测方法。方法收集4家医疗机构留存的4类人群的HIV抗体阴性血样,对血样进行Pooling PCR法检测,并计算人均检测成本。结果男男同性恋人群HIV核酸阳性率为554.27/万,性病门诊就诊者人群次之,为不低于119.13/万,体检人群没有发现HIV核酸阳性;医疗机构1(结核病防治机构)的其他就诊者人群核酸阳性率(≥85.54/万)要高于医疗机构2的其他就诊者人群(≥21.04/万)。4个医疗卫生机构所留存的4类人群的抗体检测阴性样本中有2类人群检出HIV病毒核酸阳性,共检出病程早期(HIV抗体阴性,但核酸阳性)样本3例,其中男男同性恋人群检出2例、性病门诊就诊者人群检出1例。结论 Pooling PCR检测技术方法敏感且经济,适合于在男男同性恋、性病门诊就诊者及结核病病人等HIV高危人群/高度可疑病人中发现病程早期HIV病毒感染者。
Objective To investigate the ability of Pooling PCR in diagnosing and identifying early stage(acute infection) HIV infected persons,and to evaluate whether this method is economical and feasible,and whether it could be used to replace the HIV antibody detection method in the diagnosis of HIV infection status in some populations. Methods HIV antibody negative blood samples were collected from 4 groups of people in 4 medical institutions. Pooling PCR was used to detect HIV-negative blood samples,and the cost of single sample was calculated. Results The positive rate of HIV nucleic acid in male homosexuals was554.27/10,000,followed by those in STD clinics,which was no less than 119.13/10,000. No HIV nucleic acid was found in the physical examination population. The positive rate of nucleic acid in other patients in medical institutions 1(>85.54/10,000) was higher than that in other patients in medical institutions 2(>21.04/10,000). HIV nucleic acid was detected in 2 out of the 4 groups of negative samples in 4 medical and health institutions,and 3 cases were detected in the early stage of disease(HIV antibody negative,but nucleic acid positive). Among them,2 cases were detected in male homosexuals and 1 case was detected in STD clinic patients. Conclusion Pooling PCR is a sensitive method with low cost. It is suitable for the detection of early HIV infection in high-risk population/highly suspicious patients such as gay men,STD clinic patients and tuberculosis patients.
Objective To investigate the ability of Pooling PCR in diagnosing and identifying early stage(acute infection) HIV infected persons,and to evaluate whether this method is economical and feasible,and whether it could be used to replace the HIV antibody detection method in the diagnosis of HIV infection status in some populations. Methods HIV antibody negative blood samples were collected from 4 groups of people in 4 medical institutions. Pooling PCR was used to detect HIV-negative blood samples,and the cost of single sample was calculated. Results The positive rate of HIV nucleic acid in male homosexuals was554.27/10,000,followed by those in STD clinics,which was no less than 119.13/10,000. No HIV nucleic acid was found in the physical examination population. The positive rate of nucleic acid in other patients in medical institutions 1(>85.54/10,000) was higher than that in other patients in medical institutions 2(>21.04/10,000). HIV nucleic acid was detected in 2 out of the 4 groups of negative samples in 4 medical and health institutions,and 3 cases were detected in the early stage of disease(HIV antibody negative,but nucleic acid positive). Among them,2 cases were detected in male homosexuals and 1 case was detected in STD clinic patients. Conclusion Pooling PCR is a sensitive method with low cost. It is suitable for the detection of early HIV infection in high-risk population/highly suspicious patients such as gay men,STD clinic patients and tuberculosis patients.
引文
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[11]李东民,葛琳,王岚,等.中国2010-2013年男男性行为人群艾滋病及相关行为变化趋势分析[J].中华流行病学杂志,2014,35(5):542-546.
[12]王成,黄澍杰,等.珠三角地区性病门诊青少年就诊者性病/HIV感染现状及影响因素分析[J].中国艾滋病性病,2018,24(6):624-625.
[13]刘雯,谭武红,朱参胜,等.2012-2014年性病门诊男性就诊者艾滋病哨点监测结果分析[J].疾病监测与控制,2015,9(9):604-605.
[14]赖钰基,成诗明,周林,等.不同艾滋病流行地区结核病患者HIV筛查效果分析[J].中国防痨杂志,2015,37(1):9-13.
[15]许静,郑全庆,等.陕西省TB与HIV/AIDS双向筛查及TB/HIV患者抗结核治疗转归队列分析[J].中国热带医学,2018,18(6):619-623.
[16]唐翼龙,易志强,等.2006年-2013年江西省各人群艾滋病病毒感染者/病人检出情况分析[J].实验与检验医学,2014,32(5):628-630.
[2]Delaney KP,Hanson DL,Masciotra S,et al.Time Until Emergence of HIV Test Reactivity Following Infection With HIV-1:Implications for Interpreting Test Results and Retesting After Exposure[J].Clin Infect Dis,2017,64(1):53-59.
[3]刘燕,钟展华,等.惠州市2013-2017年无偿献血者HIV检测结果[J].中国热带医学,2018,18(5):480-483.
[4]中国疾病预防控制中心.全国艾滋病检测技术规范(2015年修订版)[Z].2015.
[5]徐红,张庆梅,等.萧山区艾滋病自愿咨询检测门诊求询者调查[J].预防医学,2018,30(9):927-929.
[6]古彩虹,李裕标,等.梅州市2016~2017年性病门诊男性就诊者艾滋病哨点监测结果分析[J].安徽预防医学杂志,2018,24(3):213-215.
[7]郑伯敏.天津市汉沽性病门诊男性就诊者艾滋病监测分析[J].河南预防医学杂志,2018,29(10):772-774.
[8]李桂英,卢红艳,等.北京市2016年性病门诊的男性就诊者HIV检测结果分析[J].中国预防医学杂志,2018,19(7):536-540.
[9]张佳峰,丁晓贝,等.HIV核酸检测在夫妻传播风险评价中的实例应用[J].中国艾滋病性病,2018,24(7):650-652.
[10]杨慧,胡艳霞,等.济南市男男性行为人群艾滋病病毒感染及相关因素分析[J].中华疾病控制杂志,2015,19(12):1235-1239.
[11]李东民,葛琳,王岚,等.中国2010-2013年男男性行为人群艾滋病及相关行为变化趋势分析[J].中华流行病学杂志,2014,35(5):542-546.
[12]王成,黄澍杰,等.珠三角地区性病门诊青少年就诊者性病/HIV感染现状及影响因素分析[J].中国艾滋病性病,2018,24(6):624-625.
[13]刘雯,谭武红,朱参胜,等.2012-2014年性病门诊男性就诊者艾滋病哨点监测结果分析[J].疾病监测与控制,2015,9(9):604-605.
[14]赖钰基,成诗明,周林,等.不同艾滋病流行地区结核病患者HIV筛查效果分析[J].中国防痨杂志,2015,37(1):9-13.
[15]许静,郑全庆,等.陕西省TB与HIV/AIDS双向筛查及TB/HIV患者抗结核治疗转归队列分析[J].中国热带医学,2018,18(6):619-623.
[16]唐翼龙,易志强,等.2006年-2013年江西省各人群艾滋病病毒感染者/病人检出情况分析[J].实验与检验医学,2014,32(5):628-630.