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目的了解大连市人类免疫缺陷病毒(HIV)抗体筛查实验与确证实验结果符合率,为提高实验室HIV抗体检测技术提供依据。方法按照《全国艾滋病检测技术规范》(2009版)的检测方法和要求,对大连市初筛送检的512份阳性样品采用免疫印迹法(WB)进行确认。结果512份筛查阳性者中,HIV-1阳性368份占71.88%,不确定78份占15.23%,阴性66份占12.90%。368份HIV-1阳性标本中,男性占93.75%,女性占6.25%;未婚、已婚、离异分别占54.35%、26.09%、19.57%;文化程度为文盲、小学、初中、高中、大专及大专以上分别占1.36%、5.43%、26.36%、24.46%、42.39%;≤29岁及以下占42.93%,30~39岁占23.91%,40~49岁占19.29%,≥50岁占13.86%。WB带型分布,出现9条带的占36.14%,8条带占31.79%,7条带占24.73%,6条带占3.53%,6条带及以上合计占93.75%。抗env基因编码蛋白抗体、抗pol基因编码抗体、gag基因编码蛋白抗体的平均阳性率分别为98.64%、94.38%、69.65%;不确定样本分别为22.22%、2.14%、35.47%。不确定的样本完成追踪检测的26人,其中,转为阳性9人,占34.62%;转为阴性的17人,占65.38%。结论艾滋病筛查实验室应进一步加强实验室规范化管理,消除引起初筛试验假阳性结果的因素。不确定者的带型绝大多数不含抗pol基因编码的抗体。HIV感染者男性多于女性,未婚占多数,高学历占多数,低龄化趋势明显。
Objective To understand the coincidence rate of HIV antibody screening and confirmatory test results in Dalian, and to provide basis for improving HIV antibody detection in laboratory. Methods According to the testing methods and requirements of “National AIDS Testing Technical Specification” (2009 Edition), 512 positive samples submitted for screening in Dalian were confirmed by Western blotting (WB). Results Of the 512 screening positives, 368 were positive for HIV-1 accounting for 71.88%, 78 were unsure, 15.23% were negative, and 66 were negative for 12.90%. Of the 368 HIV-1 positive specimens, 93.75% were males and 6.25% were females; those who were unmarried, married and separated accounted for 54.35%, 26.09% and 19.57% respectively; and those with a literacy level of education were primary, middle school, high school, college and college Accounting for 1.36%, 5.43%, 26.36%, 24.46% and 42.39% respectively; 42.93% ≤29 and below, 23.91% from 30 to 39, 19.29% from 40 to 49, and 13.86% over 50. WB bands, with 9 bands accounting for 36.14%, 8 bands accounting for 31.79%, 7 bands accounting for 24.73%, 6 bands accounting for 3.53% and 6 bands or more accounting for 93.75%. The average positive rates of anti-env gene encoding protein antibody, anti-pol gene encoding antibody and gag gene encoding protein antibody were 98.64%, 94.38%, 69.65% respectively; the uncertain samples were 22.22%, 2.14%, 35.47% respectively. Uncertain samples completed follow-up testing of 26 people, of which, turned positive 9, accounting for 34.62%; turned negative 17, accounting for 65.38%. Conclusion AIDS screening laboratories should further strengthen the standardization of laboratory management, eliminating the false positive results of the initial screening test. The majority of the unidentified bands are free of anti-pol gene-encoded antibodies. More HIV-infected men than women, unmarried majority, highly educated majority, the trend of younger age obvious.