亳州市2016年-2017年HIV抗体筛查阳性反应标本复核及确证试验结果分析
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摘要
目的分析亳州市2016年-2017年HIV抗体筛查阳性标本的复核和确证试验结果,为艾滋病防治提供依据。方法对HIV抗体筛查阳性反应的标本进行复核,复核阳性的标本用免疫印迹试验进行确证,不确定标本进行随访或病毒核酸检测。结果 415份筛查阳性反应标本复核阳性反应符合率为92.29%;确证试验阳性率为86.16%;不确定占8.09%;送检机构确证阳性率由高到低分别为疾病预防控制机构(90.24%)、医疗机构(80.12%)及采供血机构(27.27%);31份不确定标本病毒核酸检测>5 000拷贝/ml的有12例,随访到23例,阳转12例,阳转的带型主要为gp160、gp41和p24等的组合模式。结论疾病预防控制机构开展的VCT和医疗机构规范的PITC工作是发现艾滋病感染者的重要途径;对出现gp160、gp41和p24等带型的不确定标本要加强随访,对有高危行为的极早期病例要做病毒核酸检测,以尽快辅助诊断。
Objective To analyze the verification and confirmation results of positive HIV antibody screening specimens in Bozhou during 2016-2017, so as to provide basis for AIDS prevention and treatment. Methods The positive specimens of HIV antibody screening were rechecked and confirmed by Western blot test; The unconfirmed specimens were followed up or conducted for the detection of virus nucleic acid. Results The positive coincidence rate of the rechecked 415 specimens with positive screening results was 92.29%, the positive rate of confirmation test was 86.16%, the uncertainty was 8.09%; The positive rate in inspection institution was, from high to low, in the order of disease control agency(90.24%), medical institution(80.12%) and blood supply mechanism(27.27%); In 31 undetermined specimens, there were 12 cases with virus nucleic acid > 5 000 cop/ml, 23 cases were followed up, 12 cases were positive conversion, and the positive transformation type was mainly in a combined mode of gp160, gp41 and p24. Conclusion VCT and the standardized PITC in CDC and medical institutions are important ways to find HIV infection, the undetermined specimens with gp160, gp41 and p24 should be followed up, and the early cases with high-risk behavior should be tested to assist the diagnosis as soon as possible.
Objective To analyze the verification and confirmation results of positive HIV antibody screening specimens in Bozhou during 2016-2017, so as to provide basis for AIDS prevention and treatment. Methods The positive specimens of HIV antibody screening were rechecked and confirmed by Western blot test; The unconfirmed specimens were followed up or conducted for the detection of virus nucleic acid. Results The positive coincidence rate of the rechecked 415 specimens with positive screening results was 92.29%, the positive rate of confirmation test was 86.16%, the uncertainty was 8.09%; The positive rate in inspection institution was, from high to low, in the order of disease control agency(90.24%), medical institution(80.12%) and blood supply mechanism(27.27%); In 31 undetermined specimens, there were 12 cases with virus nucleic acid > 5 000 cop/ml, 23 cases were followed up, 12 cases were positive conversion, and the positive transformation type was mainly in a combined mode of gp160, gp41 and p24. Conclusion VCT and the standardized PITC in CDC and medical institutions are important ways to find HIV infection, the undetermined specimens with gp160, gp41 and p24 should be followed up, and the early cases with high-risk behavior should be tested to assist the diagnosis as soon as possible.
引文
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[11] 吴洪明. 核酸检测技术在基层血站血液筛查中的应用[J]. 医学伦理与实践, 2018, 31(1): 111-112.
[12] 中国疾病预防控制中心性病艾滋病预防控制中心. 2015年第一季度全国艾滋病性病疫情及主要防治工作进展[J]. 中国艾滋病性病, 2015, 21(5): 353-353.
[13] 王险峰, 李峰, 刘晓松, 等. 2013-2015年石家庄市HIV确证结果分析[J]. 江苏预防医学, 2017, 28(3): 163-165.
[14] 刘建敏, 董雪, 李欣, 等. 沈阳市2013年HIV抗体初筛阳性标本的复检及确证结果分析[J]. 中国卫生检验杂志, 2015, 25(6): 844-845.
[15] 周乐, 黄瑶, 张伟, 等. 扬州市2012-2013年HIV确证实验结果分析[J]. 江苏预防医学, 2016, 27(7): 423-425.
[2] 中国疾病预防控制中心. 全国艾滋病检测技术规范(2015修订版)[Z]. 2015-12.
[3] 晏嘉璐, 杨晋川, 童晶, 等. 2012-2013年徐州市HIV～1/2抗体筛查阳性标本确证结果分析[J]. 江苏预防医学, 2015, 26(2): 22-23.
[4] 杨斌, 刘静, 肖俊, 等. 2013-2015年黔东南州艾滋病抗体筛查阳性标本确证结果分析[J]. 母婴世界, 2016, 10(5): 242-243.
[5] 孙琦, 徐莉, 张化江, 等. 2011-2014年威海市HIV抗体筛查阳性标本的确证结果分析[J]. 中国艾滋病性病, 2015, 21(11): 982-984, 989.
[6] 王中秋. HIV抗体筛查阳性标本的确证结果分析[J]. 实用预防医学, 2012, 19(11): 1719-1721.
[7] 张伟宏, 纳玮, 张晓萍. 526例HIV抗体初筛阳性标本复核、确证结果分析[J]. 宁夏医学杂志, 2017, 39(4): 370-372.
[8] 高赛珍, 欧慧, 黄宗杰, 等. 500例HIV抗体筛查阳性样本确证检测[J]. 实用预防医学, 2016, 23(5): 532-534.
[9] 龙永艳, 魏芳芳, 冯长华, 等. 645例HIV抗体筛查阳性样本确证检测分析[J]. 实用预防医学, 2014, 21(3): 368-369.
[10] 赵勇. 第3代和第4代HIV检测试剂在血液检测中的结果分析[J]. 中国医药指南, 2012, 10(9): 390-391.
[11] 吴洪明. 核酸检测技术在基层血站血液筛查中的应用[J]. 医学伦理与实践, 2018, 31(1): 111-112.
[12] 中国疾病预防控制中心性病艾滋病预防控制中心. 2015年第一季度全国艾滋病性病疫情及主要防治工作进展[J]. 中国艾滋病性病, 2015, 21(5): 353-353.
[13] 王险峰, 李峰, 刘晓松, 等. 2013-2015年石家庄市HIV确证结果分析[J]. 江苏预防医学, 2017, 28(3): 163-165.
[14] 刘建敏, 董雪, 李欣, 等. 沈阳市2013年HIV抗体初筛阳性标本的复检及确证结果分析[J]. 中国卫生检验杂志, 2015, 25(6): 844-845.
[15] 周乐, 黄瑶, 张伟, 等. 扬州市2012-2013年HIV确证实验结果分析[J]. 江苏预防医学, 2016, 27(7): 423-425.