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目的应用核酸扩增检测(Nucleic Acid Amplification Testing,NAT)技术对人类免疫缺陷病毒(human im-munodeficiency virus,HIV)酶联免疫吸附测定(Enzyme-Linked Immuno Sorbent Assay,ELISA)合格的献血者血液标本进行核酸检测,探讨NAT技术对缩短ELISA检测HIV感染“窗口期”的作用。方法对献血者血液标本进行HIV抗原抗体、乙型肝炎病毒表面抗原、丙型肝炎病毒抗体、梅毒螺旋体抗体2遍ELISA检测,将检测结果合格的血液标本进行核酸检测。结果在177229例ELISA检测合格的献血者标本中发现HBV DNA阳性献血者24例,HIV-1RNA阳性献血者1例,未发现HCV RNA阳性献血者。对HIV-1RNA阳性献血者追踪调查并在献血后的d4、d11、d16、d37采样检测,d4病毒载量由献血时的4.61×102copy/ml上升至5.10×104copy/ml,P24抗原和抗体仍为阴性;d11P24抗原检测阳性,HIV抗体检测仍为阴性。d16HIV抗体检测结果阳性,免疫印迹法(Western blot,WB)确证试验结果为HIV抗体不确定;d37WB确证试验结果为HIV-1抗体阳性。结论 HIV-1RNA阳性献血者,经追踪调查及对不同时间采集的标本采用各种方法学检测,证实该献血者为HIV感染早期ELISA法漏检的“窗口期”献血者。因此,NAT检测技术比ELISA检测能更进一步地缩短HIV检测的“窗口期”。
Objective To detect the blood samples of blood donors qualified by human immunodeficiency virus (HIV) Enzyme-Linked Immuno Sorbent Assay (ELISA) with Nucleic Acid Amplification Testing (NAT) Nucleic acid test to explore NAT technology to shorten the ELISA detection of HIV infection “window period ” role. Methods Blood samples of blood donors were tested for HIV by two times ELISA with HIV antigen antibody, hepatitis B virus surface antigen, Hepatitis C virus antibody and Treponema pallidum antibody, and the blood samples with qualified test results were used for nucleic acid detection. Results Twenty-four (24) patients with positive HBV DNA and 1 HIV-1 RNA-positive donor were found in 177229 ELISA-positive blood donors. No HCV RNA positive blood donor was found. HIV-1 RNA positive blood donors were followed up and d4, d11, d16 and d37 after blood donation were tested. The d4 viral load increased from 4.61 × 102copy / ml at the time of donation to 5.10 × 104 copies / ml, P24 antigen and antibody still Negative; d11P24 antigen test positive, HIV antibody test is still negative. d16HIV antibody test results were positive, Western blot (WB) confirmed that the test results for the HIV antibody uncertainty; d37WB confirm the test results for the HIV-1 antibody positive. Conclusions HIV-1 RNA positive donors were tested by follow-up investigation and samples taken at different times, and the blood donors were confirmed as “window stage ” blood donors missed by the early ELISA of HIV infection. Therefore, NAT detection technology can further shorten the “window period” of HIV detection than ELISA detection.