两种补充试验在艾滋病诊断中的应用分析
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摘要
目的探讨两种补充试验在艾滋病诊断中的应用价值。方法对98例艾滋病诊断疑难病例进行3周随访检测蛋白印迹试验(WB)和1周病毒载量(VL)检测,比较两种检测方法对疑难病例的诊断效果。结果 98例艾滋病诊断疑难病例中,3周WB阳转数为26例(26.5%),而1周内VL>5 000拷贝/mL判阳数为50例(50.1%),且26例的VL结果均>5 000拷贝/mL,其中6种带型的VL阳转率均比WB阳转率高,VL能更早地做出诊断。另外1例四代初筛阳性三代初筛阴性,WB无特性条带的病例在1周内检测VL,结果即可判断阳性。结论病毒载量检测能对艾滋病疑难样本做出快速有效的诊断,也能对非特异性反应做出准确的鉴别。研究建议筛查阳性标本先进行WB检测,遇疑难样本立即采集血浆检测病毒载量,两种补充实验互相补充,即可达到快速有效诊断又可减轻实验成本。
Objective To explore the application value of two supplementary tests for AIDS diagnosis. Methods 98 cases of AIDS were followed up for 3 weeks to detect WB and 1 week viral load, and the diagnostic effects of the two methods were compared. Results Among 98 cases of AIDS difficult to diagnose, WB positive revolution was 26 cases(26.5%) in 3 weeks, while VL>5 000 cps/ml positive number was 50(50.1%) cases in 1 week, and the VL results of 26 cases were all >5 000 cops/ml, among which the VL positive conversion rates of the 6 types of bands were higher than those of the others. WB positive conversion rate was high and could be diagnosed earlier. In addition, 1 case was positive in the fourth generation and negative in the third generation, and WB had no characteristic band. The patient was tested VL within 1 week and the result was positive. Conclusion Viral load test can make a rapid and effective diagnosis of difficult samples of AIDS, and can also accurately identify non-specific reactions. It is suggested that WB test should be carried out for screening positive samples. Plasma should be collected immediately to test viral load in case of the samples difficult to diagnose, and the two experiments complement each other, so as to achieve rapid and effective diagnosis and reduce the experimental cost.
Objective To explore the application value of two supplementary tests for AIDS diagnosis. Methods 98 cases of AIDS were followed up for 3 weeks to detect WB and 1 week viral load, and the diagnostic effects of the two methods were compared. Results Among 98 cases of AIDS difficult to diagnose, WB positive revolution was 26 cases(26.5%) in 3 weeks, while VL>5 000 cps/ml positive number was 50(50.1%) cases in 1 week, and the VL results of 26 cases were all >5 000 cops/ml, among which the VL positive conversion rates of the 6 types of bands were higher than those of the others. WB positive conversion rate was high and could be diagnosed earlier. In addition, 1 case was positive in the fourth generation and negative in the third generation, and WB had no characteristic band. The patient was tested VL within 1 week and the result was positive. Conclusion Viral load test can make a rapid and effective diagnosis of difficult samples of AIDS, and can also accurately identify non-specific reactions. It is suggested that WB test should be carried out for screening positive samples. Plasma should be collected immediately to test viral load in case of the samples difficult to diagnose, and the two experiments complement each other, so as to achieve rapid and effective diagnosis and reduce the experimental cost.
引文
[1] 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)[M].中国疾病预防控制中心,2015:34-40.
[2] 楚承霞,赵山平,刘芳芳.HIV抗体不确定标本158例的结果及随访转归观察[J].检验医学与临床,2013,10(6):659-660.
[3] 缪礼锋,沈月兰,吴建军,等.HIV抗体蛋白印迹试验不确定结果的血清学特征及病毒载量辅助诊断的意义[J].中国艾滋病性病,2016,22(3):150-154.
[4] 鲍作义,刘永健,王海燕.HIV抗体免疫印迹试验不确定结果的特征及鉴别方法[J].中华流行病学杂志,2008,29(5):478-481.
[5] 李燕,梁彩云,高凯,等.HIV抗体不确定患者的随访转归及相关生物学因素[J].中华预防医学杂志,2011,45(10):916-919.
[6] 鲍作义,杨晓莉,刘永健,等.HIV抗体不确定结果的特征与鉴别方法研究[J].中华微生物学和免疫学杂志,2013,30(5):427-430.
[7] 吴可可,李伟,虞成超,等.HIV-1抗体不确定标本的血清学特征与病毒载量[J].中国卫生检验杂志,2015,25(2):202-203.
[8] 彭瑾瑜,贺健梅,江洋,等.湖南省2008—2012年HIV抗体不确定结果分析[J].中国艾滋病性病,2014,20(4):240-243.
[9] 张秀娟,张蕾,李霞.HIV-1抗体不确定者跟踪监测结果分析[J].中国卫生检验杂志,2015,25(14):2396-2398.
[10] 薛以乐,郑晓虹,方蕙,等.HIV 病毒载量定量测定方法的比较研究[J].上海预防医学杂志,2001,13(7):306-307.
[11] 高敏,吴守丽,严延生.HIV 抗体不确定的影响因素及其检测方法的研究进展[J].中国艾滋病性病,2016,22(4):308-311.
[12] 常俊峰.三种 HIV 抗原/抗体检测方法对HIV早期感染检测的诊断研究[J].中国免疫学杂志,2015,31(8):1082-1084.
[13] Le T,Wright EJ,Smith DM,et al.Enhanced CD4 +T-cell recovery with earlier HIV-1 antiretroviral therapy[J].N Engl J Med,2013,368(3):218-230.
[14] Cohen MS,Chen YQ,McCauley M,et al.Prevention of HIV-1 infection with early antiretroviral therapy[J].N Engl J Med,2011,365(6):493-505.
[15] Fidler S,Porter K,Ewings F,et al.Short-course antiretroviral therapy in primary HIV infection[J].N Engl J Med,2013,368(3):207-217.
[16] 张静瑜,栾荣生,罗映娟,等.2012年四川省艾滋病高危人群哨点监测结果分析[J].中国艾滋病性病,2014,20(2):91-94.
[2] 楚承霞,赵山平,刘芳芳.HIV抗体不确定标本158例的结果及随访转归观察[J].检验医学与临床,2013,10(6):659-660.
[3] 缪礼锋,沈月兰,吴建军,等.HIV抗体蛋白印迹试验不确定结果的血清学特征及病毒载量辅助诊断的意义[J].中国艾滋病性病,2016,22(3):150-154.
[4] 鲍作义,刘永健,王海燕.HIV抗体免疫印迹试验不确定结果的特征及鉴别方法[J].中华流行病学杂志,2008,29(5):478-481.
[5] 李燕,梁彩云,高凯,等.HIV抗体不确定患者的随访转归及相关生物学因素[J].中华预防医学杂志,2011,45(10):916-919.
[6] 鲍作义,杨晓莉,刘永健,等.HIV抗体不确定结果的特征与鉴别方法研究[J].中华微生物学和免疫学杂志,2013,30(5):427-430.
[7] 吴可可,李伟,虞成超,等.HIV-1抗体不确定标本的血清学特征与病毒载量[J].中国卫生检验杂志,2015,25(2):202-203.
[8] 彭瑾瑜,贺健梅,江洋,等.湖南省2008—2012年HIV抗体不确定结果分析[J].中国艾滋病性病,2014,20(4):240-243.
[9] 张秀娟,张蕾,李霞.HIV-1抗体不确定者跟踪监测结果分析[J].中国卫生检验杂志,2015,25(14):2396-2398.
[10] 薛以乐,郑晓虹,方蕙,等.HIV 病毒载量定量测定方法的比较研究[J].上海预防医学杂志,2001,13(7):306-307.
[11] 高敏,吴守丽,严延生.HIV 抗体不确定的影响因素及其检测方法的研究进展[J].中国艾滋病性病,2016,22(4):308-311.
[12] 常俊峰.三种 HIV 抗原/抗体检测方法对HIV早期感染检测的诊断研究[J].中国免疫学杂志,2015,31(8):1082-1084.
[13] Le T,Wright EJ,Smith DM,et al.Enhanced CD4 +T-cell recovery with earlier HIV-1 antiretroviral therapy[J].N Engl J Med,2013,368(3):218-230.
[14] Cohen MS,Chen YQ,McCauley M,et al.Prevention of HIV-1 infection with early antiretroviral therapy[J].N Engl J Med,2011,365(6):493-505.
[15] Fidler S,Porter K,Ewings F,et al.Short-course antiretroviral therapy in primary HIV infection[J].N Engl J Med,2013,368(3):207-217.
[16] 张静瑜,栾荣生,罗映娟,等.2012年四川省艾滋病高危人群哨点监测结果分析[J].中国艾滋病性病,2014,20(2):91-94.