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目的探求适合在艾滋病自愿咨询检测(VCT)点应用的检测艾滋病病毒(HIV)抗体的替代策略。方法从河南、安徽和山西省的27个VCT检测点日常工作中采集样品10 310份,离心分离血浆后,全部用HIV快速检测试剂1(RT1)和HIV快速检测试剂2(RT2)进行检测,其中任何一种试剂的检测结果为阳性时,分别用酶联免疫吸附试验(ELISA)试剂和免疫印迹试验(WB)试剂复检。当两种快速检测均为阴性时,保留血浆,集中用ELISA试剂复检,复检为阳性者,进一步用WB确认检测。结果RT1检测为阳性的样品418份,WB确认阳性的样品386份;RT2检测为阳性的样品427份,WB确认阳性的样品388份;RT1和RT2均为阳性的样品391份,WB确认阳性的样品386份。RT1和RT2检测结果不一致的样品共63份,57份为ELISA阴性,6份为ELISA阳性。结论使用任何一种HIV快速检测试剂可以筛查出99%以上的阴性样品;两种HIV快速检测试剂的检测结果均为阳性时,可以筛查出98%以上的阳性样品;两种HIV快速检测试剂的检测结果不一致时,ELISA复检为阴性的样品可按HIV抗体阴性咨询,ELISA复检为阳性的样品应进一步做WB确认检测。使用RT1+RT2+ELISA策略,可以替代98.54%的WB确认检测,并且与WB确认检测结果的符合率为99.94%,因而可以在保证检测结果质量的同时,大大减少检测费用,提高检测效率和成本效益。
Objective To explore alternative strategies for detecting HIV antibodies suitable for VCT applications. Methods A total of 10 310 samples were collected from 27 routine VCT testing sites in Henan, Anhui and Shanxi Provinces. After centrifugation, the plasma samples were all detected by RT1 and RT2. When the test results of any one of the reagents were positive, they were re-examined by enzyme-linked immunosorbent assay (ELISA) and Western blotting (WB) reagents, respectively. When both rapid tests were negative, the plasma was retained, the concentration re-tested with an ELISA reagent, the retest was positive, and the test was further confirmed by WB. Results 418 positive samples were detected by RT1, 386 samples were positive by WB assay, 427 samples were positive by RT2 assay, 388 samples were positive by WB assay, 391 samples were positive by RT1 and RT2, 386 samples. A total of 63 samples with inconsistent RT1 and RT2 results were detected, 57 were negative by ELISA and 6 were ELISA positive. Conclusions More than 99% of negative samples can be screened using any one of the HIV rapid test reagents; more than 98% of positive samples can be screened out when both HIV rapid test reagents are positive; two rapid HIV test Reagent test results are inconsistent, ELISA retest negative for HIV antibody negative consultation, ELISA retest positive samples should be further confirmed by WB. The RT1 + RT2 + ELISA strategy can replace 98.54% of the WB confirmatory test and the coincidence rate with the WB confirmed test result is 99.94%, which can greatly reduce the testing cost and improve the testing efficiency and cost while guaranteeing the quality of the test result benefit.