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目的探讨蛋白免疫印迹试验(WB)在艾滋病病毒(HIV)确证检测过程中的漏检问题,可能的原因及解决方法。方法 40份酶联免疫吸附试验(ELISA)和(或)胶体金法筛查阳性、WB实验确证阴性的样本,分析其来源、S/CO值,并进行抗体追踪复检。结果 40份样本中检出9份HIV阳性,28份阴性,3份样本流失。阴性者均来源于没有高危行为的普通人群,其中无偿献血人群13份,ELISA S/CO均<3。9份阳性样本中,6例为男男性行为人群(MSM),自愿咨询检测(VCT)3例。其中ELISA S/CO值<6的5例,>10的4例,6例最后考虑为窗口期感染,3例可能为WB试剂中反应膜出现问题。结论 WB检测漏检,可能是样本处于窗口期感染或试剂反应膜问题,实验室应综合分析筛查阳性而WB确证阴性的检测样本,要进行追踪检测,以确定其真实的HIV-1感染状况,防止漏检。
Objective To investigate the missed detection, possible causes and solutions of Western blot (WB) in HIV confirmation testing. Methods Forty ELISA samples were screened by ELISA and / or colloidal gold and negative samples were obtained by WB. The origin, S / CO value were analyzed, and antibody tracing and retesting were performed. Results Among the 40 samples, 9 were HIV positive, 28 were negative and 3 samples were lost. Negatives were all from the general population without high-risk behavior. Among them, 13 were unpaid blood donors, 3.9 were positive for ELISA S / CO, 6 were MSM, VCT, 3 cases. Among them, 5 cases with ELISA S / CO value <6, 4 cases> 10, and 6 cases finally considered window infection, and 3 cases may have problems with reaction membrane in WB reagent. Conclusion The WB test may be a window-of-infection or reagent-reactive membrane problem. The laboratory should comprehensively analyze the positive and negative WB test samples and follow up the test to determine the true HIV-1 infection status , To prevent missed inspection.