2003-2006年北京市各类艾滋病抗体检测筛查实验室确认符合率对比分析

目的通过分析2003-2006年北京市各类艾滋病抗体检测筛查实验室送检样本的确认符合率，为制定适合北京市艾滋病防治工作需要的抗体检测策略提供科学依据。方法北京市艾滋病确证中心实验室收到的HIV抗体筛查实验室送检的样本，首先同时用两种酶联试剂筛查，其一为阳性或两者均阳性的样本在本次研究中定义为“筛查阳性”，并进行蛋白免疫印迹（WB）方法确认。将北京市的所有艾滋病抗体检测筛查实验室分为5类，通过比较各类筛查实验室2003-2006年的“筛查阳性”样本的确认阳性率、确认阴性率、确认可疑率，制定出针对不同筛查实验室的抗体检测策略。结果监管系统和定点医院的筛查阳性样本确认阳性率最高，而血液系统的确认可疑率最高。结论目前北京市虽然属于艾滋病低流行地区，但在监管系统和定点医院（性病、艾滋病治疗定点医院、戒毒治疗定点医院）存在相对集中的高危人群。监管系统和定点医院的艾滋病抗体筛查阳性受检人群，适用于《全国艾滋病检测技术规范（2004年）》的WB替代检测策略Ⅱ。普通医院和疾控系统的受检人群属一般人群，仍然坚持采用常规HIV抗体检测策略。血液系统应该采取严谨规范的检测策略，应引入病毒载量检测技术提高HIV抗体检测中的不确定样本的鉴别诊断水平。

Comparison of Coincidence Rates of Antibody Detections from 5 Kinds of HIV/AIDS Screening Labs in Beijing during 2003 to 2006

Objective To analyze coincidence rates of antibody detections from all kinds of HIV/AIDS screening labs from 2003 to 2006, and provide information for the formulation of strategies for antibody detection that adapt to HIV/AIDS prevention and control in Beijing. Methods Beijing center for HIV/AIDS confirmatory test received specimens from screening testing labs and tested with two ELISA assays. Specimen that was positive in anyone of the two ELISA assays was defined as “screening positive” and further confirmed by western blot assay. HIV/AIDS antibody screening labs were classified into 5 kinds. Confirmation rates of positive, negative and indetermination in screening-positive specimens from all kinds of screening labs from 2003 to 2006 were compared to formulate stratgies for antibody detection that adapt to different screening labs. Results Confirmation positive rates of screening-positive specimens were highest in imprisonment locales （ILs） and special hospitals （SHs）, while confirmation indeterminate rate was highest in blood centers （BCs）. Conclusion Although the present prevalence rate is low in Beijing, there is high risk population comparatively concentrated in ILs and SHs. Alternative testing strategy Ⅱ instead of WB （Westem blot） in National guideline for detection of HIV/AIDS （2004） ]can be applied to HIV/AIDS screening positive population in ILs and SHs. The population for HIV/AIDS antibody detection in common hospitals （CHs） and centers for disease control and prevention （CDCs） is general, and still adapt to conventional testing strategy. BCs should adopt even more strict testing strategy to increase diagnostic level for inconclusive HIV antibody detection results, for example, introducing viral load testing.