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目的探究HIV初筛试验与确证试验的结果之间的关系,通过随访研究确证试验不确定结果的抗体进展情况。方法 2014年1月—2016年8月解放军302医院HIV抗体初筛阳性的地方患者331例,初筛方法为化学发光法,以免疫印迹法(Westem blotting,WB)作为确证试验,分析结果。并对不确定患者进行随访,分析其出现的条带,对转阳以及转阴的结果汇总统计。结果初筛S/CO值在1~5之间的有84例,阳性符合率为0.00%,5~20之间的有36例,阳性符合率为22.22%,20~100之间的有65例,阳性符合率为67.69%,大于100的有146例,阳性符合率为98.63%。免疫印迹法检测后,72例不确定结果中存在多种条带,终判定为阳性的病人有13例,判定为阴性的病人为38例,失访21例。结论化学发光试剂存在有一定的假阳性,随着S/CO值的升高,其与确证试验的阳性符合率也会升高,但是高S/CO值的标本并不一定代表感染了HIV。同时免疫印迹法检测HIV也有一定的局限性,所以建议HIV抗体的报告应该用初筛试验、复检试验、确证试验的结果进行综合判断。
Objective To explore the relationship between the HIV screening test and the confirmatory test results. The follow-up study confirmed the progress of antibody testing with uncertain results. Methods From January 2014 to August 2016, 331 patients with HIV antibody positive screening in the 302 Hospital of People’s Liberation Army were enrolled. The primary screening method was chemiluminescence method. Western blotting (WB) was used as confirmation test to analyze the results. And follow-up of patients with uncertainty, analysis of the appearance of the band, turn positive and negative results summary statistics. Results There were 84 cases with S / CO values between 1 and 5, the positive coincidence rate was 0.00%, 36 cases between 5 and 20, the positive coincidence rate was 22.22% and 65 between 20 and 100 Cases, the positive coincidence rate of 67.69%, more than 100 have 146 cases, the positive coincidence rate was 98.63%. There were many kinds of bands in 72 cases of indeterminate results after immunoblotting, 13 cases were negative, 38 cases were negative, and 21 cases were lost. Conclusions There is a certain degree of false positive for chemiluminescence reagent. With the increase of S / CO value, the positive coincidence rate with the confirmatory test will also increase. However, samples with high S / CO value do not necessarily represent HIV infection. At the same time Western blot detection of HIV also has some limitations, it is recommended that the report of HIV antibodies should be used screening test, re-examination, confirm the results of a comprehensive judgment.