摘要
目的本研究利用天津市现有的高危人群HIV-1抗体筛查检测体系,比较核酸检测、P31条带分析法与捕获酶联免疫(BED)检测组合方法,探讨天津市适合的艾滋病急性期感染检测策略。方法 2013年天津市市区自愿咨询检测门诊的男男性行为人群三代HIV筛查试剂筛查阴性的样本,采用四代HIV抗体筛查试剂进一步筛查,发现阳性后做确证实验,确证阴性及不确定者进行核酸检测;以及经第四代试剂筛查阴性的样本,采用集合核酸方法进一步检测。天津市2012-2013年部分经免疫印迹实验(WB)检测新确认的HIV抗体阳性并且CD4计数>200的感染者,BED检测判为新近和既往感染者,并进行P31条带分析。结果 2320例MSM样本三代试剂筛查并确证阳性样本140例;2180例筛查阴性的样本,应用四代试剂检测,进一步筛出19例阳性样本,进行WB检测确认6例阳性,11例阴性,2例不确定;对13例阴性及不确定样本进行核酸验证,发现4例阳性;2161例四代试剂筛查阴性样本,经集合核酸进一步检测、拆分发现阳性样本1例,总计检核酸测出5例阳性。294份WB阳性样本进行BED检测,117份判定为新近感染,177份为既往感染,从WB结果中p31条带情况分析,新近感染者中p31阴性者占23.9%(28/117),长期感染者0例(0/177),AIDS患者1例,占1.1%(1/95),结果差异有统计学意义。结论针对高危人群应分人群进行不同检测策略的组合,并应重点针对天津市MSM HIV阳性群体进行更加精确的新发感染时间段构成情况连续监测。
Objective To discuss the appropriate early HIV detection strategy in population at high risk in Tianjin by using existing HIV-1 antibody screening and testing system to compare the effect of combination of collection nucleic acid detection,p31 bands analysis and BED detection. Methods The serum samples were collected from men who have sex with men（ MSM） in Tianjin in 2013 for nucleic acid detection. The generation Ⅲ HIV antibodies were used to test the samples first,and reconfirming test was conducted for positive samples. For negative samples,generation Ⅳ HIV antibodies were used to test the samples then,and reconfirming test was conducted for the positive samples. For the negative samples,nucleic acid sequencing was conducted. Among the newly diagnosed HIV infection（ CD4 count 200） by WB during 2012- 2013,some were identified as recent and previous infections by BED detection and p31 bands analysis was conducted for them. Results Generation Ⅲ reagents were used to screen 2320 MSMcases and 140 positive cases were detected. For 2180 negative cases detected by generation Ⅲ reagents,generation Ⅳ reagent was used,and another 19 positive cases were detected. WB confirmed that 6 cases were positive,11 cases were negative and 2 cases were uncertain. Nucleic acid detection was conducted for the 13 negative and uncertain cases were,and 4 were positive. Among the 2161 negative cases screened by generation Ⅳreagents,collected nucleic acid detection confirmed 1 positive case. Nucleic acid detection found 5 positive cases. From p31 bands of WB results,p31 negative cases accounted for 23. 9%（ 28 /117） in the newinfection cases,No long-term infection was found（ 0 /177）,and 1 AIDS case was found with a ratio of 1. 1%（ 1 /95）,the difference was significant. Conclusion It is necessary to take targeted detection measures for different populations at high-risk and strengthen the consecutive surveillance in HIV positive MSMto find out their infection time and newinfection proportionin Tianjin.
出处
《疾病监测》
CAS
2016年第1期40-44,共5页
Disease Surveillance
基金
天津市卫生行业重点攻关项目(No.12KG129)~~
关键词
艾滋病病毒
新发感染
检测策略
Human immunodeficiency virus
NewHIV infection
Detection strategy
