HIV抗体不确定标本158例的结果及随访转归观察

目的了解人类免疫缺陷病毒(HIV)抗体产生不确定结果的特点及进展情况。方法分析2009～2011年昆明市158例确证检测为不确定结果标本的样本来源、蛋白印迹试验(WB)带型特点及跟踪随访情况。结果共进行WB确证检测4 582份,检测结果为不确定者158份,占3.45%。无偿献血人员筛查和孕期/产前检查人群不确定结果的检出率(分别为7.25%和7.29%)明显高于其他人群;p24(+)30.4%、p24(+)gp160(+)25.9%和gp160(+)16.5%,以这3种带型最为常见;随访到43例不确定者,WB转为阳性结果16例(37.2%),转为阴性结果27例(62.8%),11例p24(+)gp160(+)有3例转为阴性。结论无偿献血人员、孕期和产前检查人群出现WB不确定结果的预期要高于其他人群;对p24(+)gp160(+)双带型判为阳性存在风险;应加强检测工作各个环节的质量控制,避免由于标本污染而造成的不确定结果。     

南通市2011-2015年HIV抗体不确定标本的检测结果及随访分析

目的 对人类免疫缺陷病毒(H IV)抗体不确定标本的检测结果及随访情况进行分析,从而掌握其产生的原因和特征.方法 分析南通市2011-2015年HIV抗体不确定标本的人群来源、蛋白免疫印迹试验(Western blot)带型特征和部分人群的随访信息.结果 5年间共对1821份标本进行确证检测,其中HIV抗体不确定者107例,占5.88%;受血前检测人群(13.33%)和孕产期人群(11.11%)的不确定结果检出率相对较高;不确定结果的Western blot带型共检测出10个类型,其中gp160 p24组合出现次数最多;85例随访者中,酶联免疫吸附试验(ELISA)法S/CO≥6.0的不确定者转阳率明显高于0~<6.0的不确定者(P<0.05).结论 对HIV抗体不确定人群进行随访工作十分重要,同时还需积极寻求其他策略,尽早给予受检者准确结果.     

1例肝癌患者磁微粒化学发光法HIV假阳性分析

正我国艾滋病感染患者人数逐年增加,因此早期诊断和发现人类免疫缺陷病毒(HIV)感染,对预防HIV的传播、控制艾滋病的流行显得尤其重要。目前国内实验室检测HIV抗体多采用酶联免疫吸附试验(ELISA)进行初筛。但是ELISA对一些临床上低浓度标本的检测效果不好,容易出现漏诊或者误诊等问题,而磁微粒化学发光法具有灵敏度和特异度高、检测简便,结果的重复性好、线性范围也宽、并且有着安全无毒、无放射性     

无偿献血人群HIV初筛反应性样本的确认结果分析

目的探讨无偿献血者人类免疫缺陷病毒(HIV)抗体酶联免疫吸附试验(ELISA)初筛反应性结果与免疫印迹确认试验(WB)结果的关系。方法收集2013年6月-2015年6月本血站常规ELISA初筛检测HIV结果为反应性的73份无偿献血者血浆,进一步行WB确认试验,对比分析初筛和确认结果。结果经WB确认,23份HIV双试剂反应性样本中确认阳性16份,阳性符合率为21.9%(16/73),单试剂反应性样本确认结果均为阴性。随着ELISA初筛检测S/CO值的增大,初筛结果与WB确认结果符合率增加。S/CO比值为1~6时,与WB确认结果阳性符合率为0%(0/25);S/CO值为6~10时,与WB确认结果阳性符合率为13.8%(4/29);S/CO值10时,与WB确认结果阳性符合率为63.2%(12/19)。结论无偿献血者HIV ELISA初筛结果存在一定假阳性结果 ,HIV检测结果报告及献血者的管理可参照WB确认结果及ELISA初筛S/CO值。     

电化学发光免疫分析和胶体硒法联合检测HIV抗原与抗体

<正>人类免疫缺陷病毒(HIV)是引起获得性免疫缺陷综合征(AIDS)的病原体。HIV能通过被污染的血液和血制品传播也可通过性接触传播或者母婴垂直传播。检测人类免疫缺陷病毒抗体(抗-HIV)是常规使用的艾滋病诊断方法,目前在国内抗-HIV初筛中以酶联免疫法和胶体硒法较常用,但     

公告

艾滋病作为一种严重危害人类健康的疾病，已经越来越受到人们的重视，我们已经从十几万献血人员中筛查出5例HIV抗体阳性的献血者，并已取得山东省卫生防疫站艾滋病检测中心的确认。现对检测结果做分析总结如下。     

HCV分片段抗原EIA与重组免疫印迹法分析检测HCV抗体的比较研究

【目的】探讨国产丙型肝炎病毒(HCV)分片段抗体试剂的敏感性和特异性,为丙型肝炎的早期诊断和替代昂贵的进口重组免疫印迹法确认试剂(HCV RIBA3.0)提供实验依据。【方法】用HCV分片段抗体试剂检测经确认的标本中HCV-C、NS3、NS4、NS5抗体并与HCV RIBA3.0比较。【结果】82份样品中80份判定为阳性,阳性率为97.56%,2份判定为可疑,为2.4%,40份阴性样品中有2份判定可疑,为5.00%。【结论】国产分片段抗体检测试剂检测HCV抗体,与美国第三代RIBA3.0试剂的检测符合率基本一致,有低价高效的临床实用价值。     

人偏肺病毒N蛋白的原核表达及抗原活性的初步研究

目的构建人偏肺病毒(hMPV)N蛋白(hMPV-N蛋白)的原核表达载体,研究其表达效果,为临床抗体检测及预防提供基础资料。方法根据hMPV-N基因的全序列设计引物,扩增目的基因片段,连接质粒载体RSET-A,转化大肠埃希菌BL21,IPTG诱导以his为标签的目的蛋白表达,并用人血清进行检测。结果重组质粒转化诱导后,出现了与预期分子量相符的蛋白条带;采用Western blot方法,检测了102份呼吸道感染住院患儿血清标本中的抗hMPV-N蛋白IgG抗体,阳性率为53.9%。结论成功获得了hMPV-N蛋白的表达,为临床血清学检测奠定基础。     

免疫印迹法检测HIV抗体条带常见模式分析及在随访中的价值

目的了解免疫印迹法检测人类免疫缺陷病毒(HIV)抗体阳性的常见条带模式及在随访中的价值。方法回顾分析免疫印迹法检测HIV抗体为阳性的460例患者和结果为不确定的16例患者的免疫印迹法检测结果及临床资料。结果在3个基因编码的3组HIV特异性抗体中,env基因编码的包膜蛋白抗体gp160、gp120和gp41的检出率分别为100.00%、99.35%和96.30%;pol基因编码的核酸内切酶及聚合酶抗体p66、p51和p31的检出率分别为92.61%、86.96%和91.96%;gag基因编码的核心蛋白抗体p55、p39、p24和p17的检出率分别为56.30%、13.26%、100.00%、87.17%。采用免疫印迹法检测HIV抗体,共检测到34种条带模式,最常见的条带模式为gp160/gp120/p66/p55/p51/gp41/p31/p24/p17(p39缺失,占41.74%),其次为gp160/gp120/p66/p51/gp41/p31/p24/p17(p55和p39缺失,占23.70%),全条带模式占11.30%。对16例免疫印迹法结果为不确定的患者进行随访,其中首次检测含包膜蛋白抗体条带的4例患者在随访期间HIV抗体均转为阳性。HIV感染者首诊科室共涉及到28个临床科室,其中有66.31%就诊于内科相关科室。结论 HIV感染者的免疫印迹法条带检出率存在一定的差异,患者首诊的临床科室众多,医疗机构应重视HIV检测,避免获得性免疫缺陷综合征(AIDS)被误诊和漏诊。     

常规拔牙病人艾滋病病毒污染情况调查及防护

目的:对常规拔牙术中艾滋病病毒污染情况进行调查,进一步控制医源性感染。方法:随机抽取200例门诊拔牙病人的术中止血棉球,浸入盛有1ml生理盐水的无菌试管内,其浸出液用3种方法进行艾滋病病毒检测。结果:200例标本中查出1例HIV抗体阳性(0.5%)。结论:迫切要求口腔医务工作者要加强职业防护,有效防止艾滋病通过口腔科诊疗传播。     

Universal HIV Screening in Ambulatory Care Settings

Statistics reveal that clinicians are not offering or recommending routine HIV screening in almost all health care settings, despite strongly recommended clinical guidelines published in 2006 and 2013. The Centers for Disease Control and Prevention estimates that less than half of the US population aged 18–64 years has ever been tested for HIV.^1,2 To increase HIV screening rates, it is crucial to provide education on the guidelines and a mechanism for readily available testing to increase HIV screening rates. Employing evidence-based universal screening will potentially identify new HIV diagnoses earlier. Timely identification decreases the spread of HIV, reduces the complications from living with HIV, and provides significant cost savings. Undiagnosed persons living with HIV pose a substantial epidemiologic risk. Without increased HIV screening and linkage to care, ending the HIV epidemic within the United States will be unattainable.     

2006年下半年苏州市戒毒人员艾滋病、丙型肝炎、梅毒监测报告

目的 了解苏州市吸毒人群艾滋病的感染状况,为预防控制艾滋病的流行提供科学依据.方法 对苏州市戒毒所2006年下半年新入所戒毒人员艾滋病哨点监测资料进行分析.结果 494名戒毒人员中,检出艾滋病病毒(HIV)感染者12例,感染率为2.43%;酶联免疫吸附试验梅毒感染阳性率为3.44%,丙型肝炎(丙肝)感染阳性率为21.05%.12名HIV感染者均有共用注射器静脉吸毒史.注射吸毒人员的丙肝感染率49.3%万,显著高于非注射吸毒人员的丙肝感染率5.92%(x2=126.31,P＜0.005).共用过注射器或针头人员占静脉吸毒人员的61.27%.戒毒人员中4.25%通过钱或毒品交易与他人发生性行为,只有14.29%每次都用安全套.结论 苏州市吸毒人群中HIV、丙肝病毒(HCV)感染率居于全国平均水平,静脉吸毒和共用针具吸毒是HIV和HCV传播的高危因素,不洁性行为增加了HIV、HCV、梅毒由吸毒人员向其他人群传播的危险性.     

内蒙古某院2011～2013年抗HIV1／2抗体筛查与确诊结果分析

目的：调查内蒙古医科大学附属医院门诊、体检及住院人群抗人类免疫缺陷病毒（HIV）感染状况,预估呼和浩特地区人群感染情况。方法利用化学发光免疫分析技术检测2011年8月至2013年8月内蒙古医科大学附属医院门诊、体检及住院人群 HIV 感染状况,有反应性标本利用免疫印迹试验（WB）法确诊。结果共检测108367例标本,初筛阳性率为0．0212％（23/108367）,确诊阳性率为0．0148％（16/108367）;WB 法确诊阳性符合率为69．6％（16/23）。 HIV 感染者以男性为主,年龄集中在20～60岁,并且以已婚者为主,感染者职业分布广泛,传播途径以性传播为主。结论内蒙古医科大学附属医院门诊、体检及住院人群 HIV 感染率低,趋势稳定。     

HIV阳性垂体瘤患者的围手术期循证护理

目的探讨HIV阳性垂体瘤患者的围手术期循证护理。方法根据循证护理模式,对1例HIV阳性垂体瘤患者进行围手术期的循证护理,包括4个连续的过程:循证问题、循证支持、循证观察、循证应用。为此举办有关艾滋病护理培训;组织护士进行专题循证护理学习。了解到HIV感染主要是通过性接触、血液、体液暴露和母婴垂直传播,不会通过日常接触传播,因此,直接护理的基本技巧与护理其他疾病没有显著区别,特殊措施包括消毒隔离及管理问题。结果通过医、护、患的共同努力,病人手术成功痊愈出院。结论通过循证护理,减轻了病人的痛苦,提高了医疗质量,使病人获得最佳的护理。     

Pragmatic skills in people with HIV/AIDS

Purpose. Carers and health professionals who work with people with the human immunodeficiency virus (HIV) are reported to think that the communication skills of people with HIV are “odd” and a range of difficulties with communication have been identified. However, little research has examined the “pragmatic” skills of people with HIV.

Method. Five men living with AIDS were assessed on a battery of measures of componential language to exclude aphasia. Their pragmatic appropriateness as judged using the the Pragmatic Protocol was then rated by ten experienced raters from representative portions of a semi-structured interview.

Results. All cases were rated by some raters as inappropriate on: Lexical selection specificity/accuracy. 4/5 cases had problems with: fluency, turn taking quantity, turn taking interruption/overlap and vocal quality. 3/5 were scored by some raters as having problems with: intelligibility, lexical selection: cohesion, prosody, turn taking pauses, turn taking repair/revision and vocal intensity.

Conclusions. Several pragmatic behaviours consistent with what might be expected in people with mild diffuse or subcortical brain impairment were clearly observed. Whilst the cause of their perceived pragmatic inappropriateness cannot be established, the results suggest that cognitive-communication problems might be a feature of language use in people with HIV-AIDS even when AIDS-related dementia has not been diagnosed.     

Pragmatic skills in people with HIV/AIDS

Purpose. Carers and health professionals who work with people with the human immunodeficiency virus (HIV) are reported to think that the communication skills of people with HIV are “odd” and a range of difficulties with communication have been identified. However, little research has examined the “pragmatic” skills of people with HIV.

Method. Five men living with AIDS were assessed on a battery of measures of componential language to exclude aphasia. Their pragmatic appropriateness as judged using the the Pragmatic Protocol was then rated by ten experienced raters from representative portions of a semi-structured interview.

Results. All cases were rated by some raters as inappropriate on: Lexical selection specificity/accuracy. 4/5 cases had problems with: fluency, turn taking quantity, turn taking interruption/overlap and vocal quality. 3/5 were scored by some raters as having problems with: intelligibility, lexical selection: cohesion, prosody, turn taking pauses, turn taking repair/revision and vocal intensity.

Conclusions. Several pragmatic behaviours consistent with what might be expected in people with mild diffuse or subcortical brain impairment were clearly observed. Whilst the cause of their perceived pragmatic inappropriateness cannot be established, the results suggest that cognitive-communication problems might be a feature of language use in people with HIV-AIDS even when AIDS-related dementia has not been diagnosed.     

Recurrent 'Migrainelike' Episodes in Patients With HIV Disease

Recurrent transient neurological deficits have been described in human immunodeficiency virus (HIV)-infected subjects, but their frequency, pathogenesis, and outcome are still unsettled.
We describe 10 HIV-infected patients with transient neurological deficits (0.8% of all patients followed in ourdepartment during the last decade). All patients were in the advanced stage of immunological disease. None of theclinical or special investigations performed outside of the attacks indicated an underlying structural lesion of the centralnervous system. In 80% of these patients, anticardiolipin antibodies were present. The final outcome was unrelated tothese transient neurological deficits which, per se, had a benign course.
We discuss the possible etiopathogenetic mechanisms of such episodes and suggest that they may be "migrainelike"events, possibly related to transient functional circulatory abnormalities secondary to an immunologicalantiphospholipid antibody-dependent mechanism.     

Implementation and new insights in molecular diagnostics for HIV infection

Introduction: Acquired immunodeficiency syndrome (AIDS) is a kind of acquired disease that breaks down the immune system. Human immunodeficiency virus (HIV) is the causative agent of AIDS. By the end of 2016, there were 36.7 million people living with HIV worldwide. Early diagnosis can alert infected individuals to risk behaviors in order to control HIV transmission. Infected individuals are also benefited from proper treatment and management upon early diagnosis. Thanks to the public awareness of the disease, the annual increase of new HIV infections has been slowly declining over the past decades. The advent of molecular diagnostics has allowed early detection and better management of HIV infected patients.

Areas covered: In this review, the authors summarized and discussed the current and future technologies in molecular diagnosis as well as the biomarkers developed for HIV infection.

Expert Commentary: A simple and rapid detection of viral load is important for patients and doctors to monitor HIV progression and antiretroviral treatment efficiency. In the near future, it is expected that new technologies such as digital PCR and CRISPR-based technology will play more important role in HIV detection and patient management.