HIV暴露婴儿出生后不同时段核酸定性检测结果分析
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摘要
目的通过对已知感染状态的艾滋病病毒(HIV)暴露婴儿0～72 h、4～6 w干血斑样本核酸定性检测结果进行分析,探讨婴儿早期定性检测结果的准确性。方法收集117名已知HIV感染状态的婴儿出生后0～72 h、4～6 w干血斑(DBS)样本,用罗氏HIV-1核酸检测试剂盒对样本进行HIV核酸定性检测,比较感染婴儿两个时段检测结果。结果 117名已知HIV感染状态的婴儿,包括109名未感染婴儿和8名感染婴儿。109名未感染婴儿在0～72 h、4～6 w核酸定性检测特异度分别为98.2%,99.1%;8名感染婴儿中,8名婴儿在4～6 w核酸定性检测阳性,7名婴儿在0～72 h检测结果为阳性。结论婴儿出生后0～72 h检测特异度较高并有利于早发现宫内感染婴儿,同时,为避免漏检,4～6 w龄时应再次进行检测。
Objective Analysis of nucleic acid qualitative test results of 0～72 hours and 4～6 weeks of dry blood spot samples infants with HIV known infection status, To exploring the accuracy of qualitative test results for such infants during the study period. Methods Collecting Dry Blood Spot samples from them on their 0～72 hours and 4～6 weeks age, and qualitative detection of HIV-1 nucleic acid were carried out by COBAS V2.0. Comparing the results of the infected infants for 0～72 hours and 4～6 weeks. Result 117 infants with the confirmed infection are selected in this study, including 109 uninfected ones and 8 infectec. The specificity of nucleic acid qualitative detection were both 98.2% in two age groups for 109 uninfected infants, and 7 infected infants could be detected before 72 hours in these 8 positive infants. And all the infected ones could be detected during 4 weeks to 6 weeks. Conclusions Infants with high specificity within 0～72 h after birth are conducive to early detection of intrauterine infection. And redetecded during 4 weeks to 6 weeks is necessary to avoid missed inspection.
Objective Analysis of nucleic acid qualitative test results of 0～72 hours and 4～6 weeks of dry blood spot samples infants with HIV known infection status, To exploring the accuracy of qualitative test results for such infants during the study period. Methods Collecting Dry Blood Spot samples from them on their 0～72 hours and 4～6 weeks age, and qualitative detection of HIV-1 nucleic acid were carried out by COBAS V2.0. Comparing the results of the infected infants for 0～72 hours and 4～6 weeks. Result 117 infants with the confirmed infection are selected in this study, including 109 uninfected ones and 8 infectec. The specificity of nucleic acid qualitative detection were both 98.2% in two age groups for 109 uninfected infants, and 7 infected infants could be detected before 72 hours in these 8 positive infants. And all the infected ones could be detected during 4 weeks to 6 weeks. Conclusions Infants with high specificity within 0～72 h after birth are conducive to early detection of intrauterine infection. And redetecded during 4 weeks to 6 weeks is necessary to avoid missed inspection.
引文
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[2] 中华人民共和国国家卫生健康委员会.预防艾滋病、梅毒和乙肝母婴传播工作实施方案(2015)[EB/OL].(2015-06-15)[2018-11-05].http://www.nhfpc.gov.cn/fys/s3581/201506/4￣f￣2￣1￣2￣3￣f￣a￣9￣5￣5￣a￣4￣4￣a￣f￣a￣7￣5￣a￣7￣5￣d￣a￣2￣a￣d￣3￣5￣d￣6￣e.shtml.
[3] Gutierrez M,Ludwig DA,Khan SS,et al.Has highly active antiretroviral therapy increased the time to seroreversion in HIV exposed but uninfected children[J].Clinical Infectious Diseases An Official Publication of the Infectious Diseases Society of America,2012,55(9):1255.
[4] Ananworanich J,Puthanakit T,Suntarattiwong P,et al.Reduced markers of HIV persistence and restricted HIV-specific immune responses after early antiretroviral therapy in children[J].AIDS,2014,28(7):1015.
[5] 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)[S].2015.
[6] Burgard M,Blanche S,Jasseron C,et al.Performance of HIV-1 DNA or HIV-1 RNA tests for early diagnosis of perinatal HIV-1 infection during anti-retroviral prophylaxis[J].J Pediatr,2012,160(1):60-66.
[7] Technau KG,Kuhn L,Coovadia A,et al.Xpert HIV-1 point-of-care test for neonatal diagnosis of HIV in the birth testing programme of a maternity hospital:a field evaluation study[J].Lancet Hiv,2017,4(10):e442-e448.
[8] Persaud D,Gay H,Ziemniak C,et al.Absence of Detectable HIV-1 Viremia after Treatment Cessation in an Infant-NEJM[J].New England Journal of Medicine,2013,369(19):1828-1835.
[9] WHO,Global guidance on criteria and processes for validation:elimination of mother-to-child transmission (EMTCT) of HIV and syphilis[EB/OL].(2017-11-28)[2018-11-05].https://www.who.int/hiv/P-ub/mtct/en/.
[10] WHO,Update on antiretroviral regimens for treating and preventing HIV infection and update on early infant diagnosis of HIV interim guidance[EB/OL].(2018-07-23)[2018-11-05].https://www.who.int/hiv/pub/Guide-lines/A-RV2018update/en/.