Evaluation of the serodia Treponema pallidum particle agglutination, the Murex Syphilis ICE and the Enzywell TP tests for serodiagnosis of syphilis

We evaluated the Treponema pallidum haemagglutination assay (TPHA), a treponemal test, with three other treponemal tests, the Serodia T. pallidum particle agglutination assay, the Murex Syphilis ICE IgG + IgM enzyme immunoassay (EIA) and the Enzywell TP IgG + M EIA (a new rapid EIA) for use in conjunction with the rapid plasma reagin test (RPR), a non-treponemal test, for serodiagnosis of syphilis. In all, 124 serum samples were found reactive with RPR and/or TPHA after testing by the routine laboratory protocol. Twenty-three (18.5%) of them were positive only by RPR test and were evaluated as biologically false-positive, 16 were positive only by the TPHA and 84 by both the RPR and TPHA tests; one sample was non-specific (heterophile reaction) in the TPHA.Agreements of the TPHA with the Serodia TPPA, the Murex Syphilis ICE and the Enzywell TP tests were 96.7%, 100% and 99.1%, respectively.We conclude that each one of the tests, the Serodia TPPA, the Murex Syphilis ICE and the Enzywell TP, is an appropriate substitute for screening for serodiagnosis of syphilis.     

Co-infection of HIV and HBV in voluntary counseling and testing center in Abidjan

ObjectiveTo evaluate the co-infection of hepatitis B virus (HBV) and immune deficiency virus (HIV) among clients consulting at the Voluntary Counseling and Testing Center (VCT Center) of the Institut Pasteur de Côte d’Ivoire (IPCI).MethodsA cross-sectional study was conducted from April to June 2010 at the VCT of IPCI. All clients attending the VCT of IPCI for HIV test after having signed the informed consent form were included in the study. Venous blood samples were collected from the clients after an interview. Then the rapid tests for screening of HIV infection (Determine HIV 1/2 of Abbott and Genie II HIV-1/HIV-2, Bio-Rad) were performed. As for hepatitis B surface antigen (HBsAg) test, it was performed using ELISA test system using Monolisa HBsAg Ultra-Bio-Rad.ResultsOf 278 samples analyzed, 30 were positive to antibody against HIV-1, giving a seroprevalence of about 10.8%, and 35 were positive to HBsAg, giving a seroprevalence of 12.6%. As for co-infection of HIV and HBV, it was 7/278 cases about 2.5%.ConclusionsIt can be concluded that co-infection of HBV and HIV is relatively low among clients consulting at the VCT of the IPCI. Serological surveillance should be systematic in various HIV testing centers in the country. The use of rapid tests for detection of HBsAg allows a lot of tests to be realized. However, the choice of these tests depends on the evaluation results in reference laboratories and situation on ground.     

Seroprevalence of syphilis and HIV-1 during pregnancy in a teaching hospital in northwest Ethiopia

Ethiopia is one of the countries in which sexually transmitted infections are highly prevalent. However, the data needed to present a realistic picture of the infections are lacking. This study was therefore designed to determine the seroprevalence of syphilis and HIV-1 among pregnant women at the University of Gondar Teaching Hospital. A prospective cross-sectional hospital-based study was conducted between March and June, 2005. Blood samples were collected from 480 pregnant women attending the antenatal clinic of the hospital. Sera were tested for syphilis using the Rapid Plasma Regain (RPR) and Treponema pallidum hemagglutination (TPHA) kits, and serostatus for HIV infection was checked using rapid HIV diagnostic test kits following the manufacturers' instructions. The mean (+/-SD) age of the study participants was 26.1 (+/-7.2) years. The seroprevalence of syphilis was 1%. Antibodies against HIV-1 were detected in 9.6% of the pregnant women. A higher HIV-1 prevalence (13%) was observed in the 25- to 29-year-old age group followed by the 30- to 34-year-old age group (10.2%). Only one subject (2.2%) was found to be positive for both HIV-1 and syphilis. The data indicated a relatively declined prevalence of syphilis and HIV-1 among pregnant women in an urban antenatal clinic. However, incidence and behavioral studies are required to substantiate the findings.     

Sensitivity and specificity of rapid HIV testing of pregnant women in India

OBJECTIVE: Efforts to prevent HIV transmission from mother to infants in settings like India may benefit from the availability of reliable methods for rapid and simple HIV screening. Data from India on the reliability of rapid HIV test kits are limited and there are no data on the use of rapid HIV tests for screening of pregnant women. METHODS: Pregnant women attending an antenatal clinic and delivery room in Pune agreed to participate in an evaluation of five rapid HIV tests, including (a) a saliva brush test (Oraquick HIV-1/2, Orasure Technologies Inc.), (b) a rapid plasma test (Oraquick HIV-1/2) and (c) three rapid finger prick tests (Oraquick HIV-1/2; HIV-1/2 Determine, Abbott; NEVA HIV-1/2 Cadila). Results of the rapid tests were compared with three commercial plasma enzyme immunoassay (EIA) tests (Innotest HIV AB EIA, Lab systems/ELISCAN HIV AB EIA, UBI HIV Ab EIA). RESULTS: Between September 2000 and October 1, 2001, 1258 pregnant women were screened for HIV using these rapid tests. Forty-four (3.49%) of the specimens were HIV-antibody-positive by at least two plasma EIA tests. All of the rapid HIV tests demonstrated excellent specificity (96-100%). The sensitivity of the rapid tests ranged from 75-94%. The combined sensitivity and specificity of a two-step algorithm for rapid HIV testing was excellent for a number of combinations of the five rapid finger stick tests. CONCLUSION: In this relatively low HIV prevalence population of pregnant women in India, the sensitivity of the rapid HIV tests varied, when compared to a dual EIA algorithm. In general, the specificity of all the rapid tests was excellent, with very few false positive HIV tests. Based upon these data, two different rapid HIV tests for screening pregnant women in India would be highly sensitive, with excellent specificity to reliably prevent inappropriate use of antiretroviral therapy for prevention of vertical HIV transmission.     

HIV serological screening in a population of pregnant women in the Republic of Congo: suitability of different assays

Different strategies can be applied for the screening of HIV infection, depending on the local seroprevalence. Within a WHO type III strategy, we compared the results of two different second-line methods for HIV screening of a population of pregnant women in the Republic of Congo. Sera from 3614 consecutive pregnant women were tested for HIV with Genescreen Plus Ag/Ab EIA assay; positive specimens were retested with two different second-line methods. (Determine HIV-1/2 rapid test and Vironostika HIV Ag/Ab specific EIA assay). Discordant samples were tested with HIV-1/2 Western Blot and, if necessary, HIV RNA molecular assay. Of the 3614 sera, 221 were positive with Genscreen. Among them, 21 and 10 tested negative with Vironostika and Determine, respectively. A 100% correspondence with 3rd line confirmation test results was found in Genscreen positive/Vironostika negative samples, whereas a 5.5% overestimation of HIV seroprevalence was observed when Determine, instead of Vironostika, was used as second-line test. The choice of appropriate assays in adequate sequence, within the correct WHO strategy, is pivotal to minimize the risk of overtreatment of HIV infection.     

A simple and inexpensive particle agglutination test to distinguish recent from established HIV-1 infection.

OBJECTIVES: We sought to modify the Serodia HIV-1/HIV-2 particle agglutination assay (PA), a simple and cost-effective HIV assay that is used globally for the detection of HIV antibodies, as a sensitive/less sensitive test (S/LS) to identify recently infected individuals and to estimate HIV incidence. METHODS: The Serodia PA test was modified as an S/LS test (PA-LS) by using HIV antigen-coated gelatin particles at a dilution of 1:68 and a specific diluent, and calibrated using 37 HIV clade B seroconversion panels (309 samples) from Trinidad and from a commercial source that were tested at dilution intervals from 1:10 to 1:80,000. The greatest sensitivity for correctly classifying samples from recent and established infections was determined by receiver operator curve (ROC) analysis. RESULTS: At a 1:40,000 sample dilution and a days post-seroconversion cutoff of 190 days, the PA-LS test yielded a 97% sensitivity for classifying recent and established infection samples. Furthermore, at a 1:20,000 dilution, the positive predictive value for correctly identifying recently infected individuals was 99%. The PA-LS test offers a 30-44-fold cost saving over currently available S/LS tests. CONCLUSION: A modified, low cost and simple-to-perform PA test is appropriate for use in resource-limited countries, and has exhibited excellence in distinguishing recent from established HIV infection.     

Performance of rapid HIV testing using Determine HIV-1/2 for the diagnosis of HIV infection during pregnancy in Tijuana, Baja California, Mexico

The aim of this study was to evaluate the performance of the rapid antibody test Determine HIV-1/2, in pregnant women at Tijuana General Hospital. Pregnant women seeking prenatal care or admitted in labour had blood drawn for a rapid HIV test (Determine HIV-1/2), enzyme immunoassay (EIA) and Western blot. Between March and November 2003, 1068 women in labour and 1529 women in prenatal care were enrolled. The sensitivity, specificity, positive and negative predictive values were 100%, 99.8%, 77% and 100%, respectively. For women in labour, the mean time between blood collection and rapid test results was 92 minutes (range: 20-205 minutes) compared with 41 hours (range 24-120 hours) for HIV EIA (P = 0.012). All HIV-exposed infants received oral zidovudine. These findings indicate that the rapid test Determine HIV-1/2 has a high sensitivity and specificity in pregnant women. Rapid HIV testing greatly diminishes the time to diagnosis and enables prompt intervention with antiretrovirals at delivery.     

Field evaluation of five rapid diagnostic tests for screening of HIV-1 infections in rural Rakai, Uganda

The performance characteristics of HIV rapid diagnostic tests (RDTs) vary by test and by population. We assessed five commercial RDTs in Uganda where all but one RDT (Determine; Abbott Laboratories, Germany) performed close to manufacturer's expectations. Determine had low specificity (85.2%, positive predictive value 67.3%) due to false-positive results with weak-positive bands. Properly trained staff, good quality control programmes and validation of RDTs with laboratories having confirmatory testing capacity may be warranted to assure accuracy in each setting.     

Sero-epidemiology of transfusion-transmissible infectious diseases among blood donors in Osogbo, south-west Nigeria

Background:

Transfusion-transmissible infectious agents such as hepatitis B virus (HBV), human immunodeficiency virus (HIV), hepatitis C virus (HCV) and syphilis are among the greatest threats to blood safety for transfusion recipients and pose a serious public health problem. This cross-sectional study was undertaken with the aim of determining the seroprevalence of HIV, HCV, hepatitis B surface antigen (HBsAg) and syphilis and correlates the findings with sex and age to ascertain the associations, if any, in the occurrence of the pathogens.

Materials and Methods:

HBsAg, antibodies to Treponema pallidum and HCV were determined using Clinotech test strips. Antibodies to HIV types 1 and 2 were screened with Determine and Immunocomb. All the reactive samples were confirmed using enzyme-linked immunosorbent assays. Antibodies to Treponema pallidum were confirmed with a Treponema pallidum haemagglutination test.

Results:

A total of 1,410 apparently healthy prospective blood donors aged between 18 and 64 years (mean±SD, 32.58 ± 10.24 years) who presented for blood donation at the Ladoke Akintola University of Technology Teaching Hospital Blood Bank, Osogbo were studied. The male:female ratio was 6:1. Of the prospective blood donors, 406 (28.8%) had serological evidence of infection with at least one infectious marker and 36 (2.6%) had dual infections. The overall seroprevalence of HBsAg, HIV, HCV and syphilis was found to be 18.6%, 3.1%, 6.0% and 1.1%, respectively. The highest prevalences of HBsAg, HIV, HCV and syphilis infections occurred among commercial blood donors and those aged 18 to 47 years old, the most sexually active age group. There were no significant associations between pathogens except for syphilis and HIV (p > 0.001).

Conclusion:

The high seroprevalence of blood-borne pathogens among prospective blood donors in Osogbo, Nigeria calls for mandatory routine screening of blood donors for HBV, HIV, HCV and syphilis.     

Field comparison of OraQuick® ADVANCE Rapid HIV-1/2 antibody test and two blood-based rapid HIV antibody tests in Zambia

ABSTRACT: BACKGROUND: Zambia's national HIV testing algorithm specifies use of two rapid blood based antibody assays, Determine[REGISTERED SIGN]HIV-1/2 (Inverness Medical) and if positive then Uni-GoldTM Recombigen HIV-1/2 (Trinity Biotech). Little is known about the performance of oral fluid based HIV testing in Zambia. The aims of this study are two-fold: 1) to compare the diagnostic accuracy (sensitivity and specificity) under field conditions of the OraQuick[REGISTERED SIGN] ADVANCE[REGISTERED SIGN] Rapid HIV-1/2 (OraSure Technologies, Inc.) to two blood-based rapid antibody tests currently in use in the Zambia National Algorithm, and 2) to perform a cost analysis of large-scale field testing employing the OraQuick[REGISTERED SIGN]. METHODS: This was a operational retrospective research of HIV testing and questionnaire data collected in 2010 as part of the ZAMSTAR (Zambia South Africa TB and AIDS reduction) study. Randomly sampled individuals in twelve communities were tested consecutively with OraQuick[REGISTERED SIGN] test using oral fluid versus two blood-based rapid HIV tests, Determine[REGISTERED SIGN] and Uni-GoldTM. A cost analysis of four algorithms from health systems perspective were performed: 1) Determine[REGISTERED SIGN] and if positive, then Uni-GoldTM (Determine[REGISTERED SIGN]/Uni-GoldTM); based on current algorithm, 2) Determine[REGISTERED SIGN] and if positive, then OraQuick[REGISTERED SIGN] (Determine[REGISTERED SIGN]/OraQuick[REGISTERED SIGN]), 3) OraQuick[REGISTERED SIGN] and if positive, then Determine[REGISTERED SIGN] (OraQuick[REGISTERED SIGN]/Determine[REGISTERED SIGN]), 4) OraQuick[REGISTERED SIGN] and if positive, then Uni-GoldTM (OraQuick[REGISTERED SIGN]/Uni-GoldTM). This information was then used to construct a model using a hypothetical population of 5,000 persons with varying prevalence of HIV infection from 1--30 %. RESULTS: 4,458 participants received both a Determine[REGISTERED SIGN] and OraQuick[REGISTERED SIGN] test. The sensitivity and specificity of the OraQuick[REGISTERED SIGN] test were 98.7 (95 %CI, 97.5--99.4) and 99.8 (95 %CI, 99.6--99.9), respectively when compared to HIV positive serostatus. The average unit costs per algorithm were US$3.76, US$4.03, US$7.35, and US$7.67 for Determine[REGISTERED SIGN]/Uni-GoldTM, Determine[REGISTERED SIGN]/OraQuick[REGISTERED SIGN], OraQuick[REGISTERED SIGN]/Determine[REGISTERED SIGN], and OraQuick[REGISTERED SIGN]/Uni-GoldTM, respectively, for an HIV prevalence of 15 %. CONCLUSIONS: An alternative HIV testing algorithm could include OraQuick[REGISTERED SIGN] test which had a high sensitivity and specificity. The current Determine[REGISTERED SIGN]/Uni-GoldTM testing algorithm is the least expensive when compared to Determine[REGISTERED SIGN]/OraQuick[REGISTERED SIGN], OraQuick[REGISTERED SIGN]/Determine[REGISTERED SIGN], and OraQuick[REGISTERED SIGN]/Uni-GoldTM in the Zambian setting. From our field experience, oral fluid based testing offers many advantages over blood-based testing, especially with self testing on the horizon.     

Diagnostic usefulness of five screening assays for HIV in an east African city where prevalence of infection is low

Five commercial screening assays for HIV-1, evaluated for their usefulness in detecting infection in high-risk groups in the East African country of Djibouti, produced varying degrees of performance when compared to Western blot and immunofluorescence confirmatory assays. In this population with a low prevalence of HIV infection (16/599), two enzyme-linked immunosorbent assays (ELISA; Abbott and Elavia) and two rapid assays (cambridge latex agglutination and Du Pont's HIV-CHEK) exhibited less than optimal sensitivities. However, with the exception of Elavia, these assays displayed excellent specificities. The fifth test (Serodia gelatin agglutination) produced the highest sensitivity (0.938) and negative predictive value but the lowest specificity and positive predictive value of all five tests. False positive reactions, which occurred only with the Elavia and Serodia tests, could not be explained on the basis of early infection in patients or cross-reactions with the related retroviruses HIV-2 and HTLV-I. We conclude that none of the five tests alone is sufficient in this testing situation, but that a combination of tests could satisfy most requirements for identifying HIV-1 reactive and non-reactive sera.     

HIV抗体快速检测试剂在北京MSM中应用的真实性评价

目的评价艾滋病病毒（HIV）抗体快速检测试剂,应用于男男性行为人群（MSM）中检测的真实性。方法用两种HIV抗体口腔黏膜渗出液快速检测试剂和指尖血HIV抗体快速检测试剂,对MSM进行快速检测。同时每位调查对象抽取静脉血,用酶联免疫吸附试验（ELISA）检测HIV抗体,阳性者用蛋白免疫印迹法（WB）进行确认检测。以ELISA和WB结果作为金标准,将快速检测结果与之相比较。结果 HIV抗体口腔黏膜渗出液快速检测试剂1的阴性样本检测错误百分比为6.4%（6/94）,阳性样本检测错误百分比为0.1%（1/800）。HIV抗体口腔黏膜渗出液快速检测试剂2的阴性样本检测错误百分比为25.2%（26/103）,阳性样本检测错误百分比为0（0/795）。指尖血检测的阴性样本检测错误百分比为0（0/197）,阳性样本检测错误百分比为0.1%（1/1595）。结论两种口腔黏膜渗出液快速检测试剂都可能导致一部分HIV感染者漏检。在选择口腔黏膜渗出液快速检测试剂时需要进行多方比较和评价,同时加强对开展HIV抗体快速检测的MSM志愿者的培训。对HIV抗体口腔黏膜渗出液快速检测结果的咨询显得尤为重要。     

一种唾液快速检测HIV-1/2型抗体试剂的现场评价

目的对一种唾液快速检测艾滋病病毒Ⅰ/Ⅱ型(HIV-1/2)抗体试剂进行现场评价,考核其现场使用的敏感性和特异性,以及与血液HIV-1/2抗体检测试剂的一致性。方法采集247例已知HIV感染者、1 090例正常献血人员、60例患有其它疾病的患者(包括孕妇、肿瘤患者、一般疾病患者),以及109例HCV感染者和119例未知HIV感染状况的吸毒人员的唾液标本,现场使用Vanguard OMTTM唾液HIV-1/2抗体快速检测试剂盒(CalypteBiomedical生产)进行检测,同时平行采集上述人群的血液标本,使用Vironostika HIV Uni-FormⅡplus O(BioMerieux生产)进行对比测试。结果247例已知HIV感染者中,247例唾液标本HIV-1/2型抗体检测均为阳性。1 259例血液酶联免疫吸附试验(ELISA)检测HIV抗体阴性人群中,1 257例唾液检测为阴性,2例为阳性。119例吸毒人员中,28例血液标本HIV阳性中,唾液标本检出27例。91例HIV阴性中检出阴性90例。该唾液HIV抗体快速检测试剂,敏感性为99.64%,特异性为99.78%。与ELISA检测的一致性为99.75%。结论唾液HIV-1/2型抗体检测试剂与现行的血液ELISA检测结果相近。唾液标本的采集方便而且危险性小,推荐在采血较困难的人群、基层医疗机构、VCT门诊等,可考虑使用唾液HIV-1/2型抗体快速检测试剂进行HIV抗体初筛检测。     

Prevalence and virological profiles of hepatitis B infection in human immunodeficiency virus patients

AIM: To determine the prevalence of hepatitis B virus (HBV) in adult human immunodeficiency virus (HIV) patients with CD4+ T-cell count less than 500/mm 3 and without antiretroviral therapy; to describe different HBV-HIV coinfection virological profiles; and to search for factors associated with HBs antigen (HBsAg) presence in these HIV positive patients.METHODS: During four months (June through September 2006), 491 patients were received in four HIV positive monitoring clinical centers in Abidjan. Inclusion criteria: HIV-1 or HIV-1 and 2 positive patients, age ≥ 18 years, CD4+ T-cell count < 500/mL and formal and signed consent of the patient. Realized blood tests included HIV serology, CD4+ T-cell count, quantitative HIV RNA load and HBV serological markers, such as HBsAg and HBc antibody (anti-HBcAb). We performed HBeAg, anti-HBe antibody (anti-HBeAb), anti-HBc IgM and quantitative HBV DNA load in HBsAg positive patients. Anti-HBsAb had been tested in HIV patients with HBsAg negative and anti-HBcAb-positive. HBV DNA was also tested in 188 anti-HBcAb positive patients with HBsAg negative status and without anti-HBsAb. Univariate analysis (Pearsonχ 2 test or Fischer exact test) and multivariate analysis (backward step-wise selection logistic regression) were performed as statistical analysis. RESULTS: Mean age of 491 patients was 36 ± 8.68 years and 73.3% were female. Type-1 HIV was found in 97% and dual-type HIV (type 1 plus type 2) in 3%. World Health Organization (WHO) clinical stage was 1, 2, 3 and 4 respectively in 61 (12.4%), 233 (47.5%), 172 (35%) and 25 patients (5.1%). Median CD4+ T-cell count was 341/mm 3 (interquartile range: 221-470). One hundred and twelve patients had less than 200 CD4+ T-cell/mm 3 . Plasma HIV-1 RNA load was elevated (≥ 5 log 10 copies/mL) in 221 patients (45%). HBsAg and anti-HBcAb prevalence was respectively 13.4% and 72.9%. Of the 66 HBsAg positive patients, 22 were inactive HBV carriers (33.3%), 21 had HBeAg positive hepatitis (31.8%) and 20 had HBeAg negative hepatitis (30.3%). HBeAg and anti-HBeAb were indeterminate in 3 of them. Occult B infection prevalence (HBsAg negative, anti-HBcAb positive, anti-HBsAb negative and detectable HBV DNA) was 21.3%. Three parameters were significantly associated with the presence of HBsAg: male [odds ratio (OR): 2.2;P = 0.005; 95% confidence interval (CI): 1.3-3.8]; WHO stage 4 (OR: 3.2;P = 0.01;95% CI: 1.3-7.9); and aspartate aminotransferase (AST) level higher than the standard (OR: 1.9;P = 0.04; 95% CI: 1.02-3.8). CONCLUSION: HBV infection prevalence is high in HIV-positive patients. HBeAg positive chronic hepatitis and occult HBV infection are more frequent in HIVpositive patients than in HIV negative ones. Parameters associated with HBsAg positivity were male gender, AIDS status and increased AST level.     

Assessment of the rapid test based on an immunochromatography technique for detecting anti-Treponema pallidum antibodies

A rapid test based on an immunochromatography assay - Determine Syphilis TP (Abbott Lab.) for detecting specific antibodies to Treponema pallidum was evaluated against serum samples from patients with clinical, epidemiological and serological diagnosis of syphilis, patients with sexually transmitted disease other than syphilis, and individuals with negative serology for syphilis. The Determine test presented the sensitivity of 93.6%, specificity of 92.5%, and positive predictive value and negative predictive value of 95.2% and 93.7%, respectively. One serum sample from patient with recent latent syphilis showed a prozone reaction. Determine is a rapid assay, highly specific and easy to perform. This technique obviates the need of equipment and its diagnostic features demonstrate that it may be applicable as an alternative assay for syphilis screening under some emergency conditions or for patients living in remote localities.     

Evaluation of seven immunological assay reagents for hepatitis B virus surface antigen (HBsAg) in the sensitivity and the detection of HBsAg mutants

Mutants of hepatitis B virus surface antigen (HBsAg) are known as a cause of false-negative results in diagnostic tests for HBsAg; particularly when a diagnostic kit utilizes monoclonal antibodies to detect HBsAg. We compared seven HBsAg kits with regard to sensitivity for HBsAg subtypes (ad, ay) and their ability to detect nine different HBsAg mutants. Among them, the sensitivities of five kits were high and comparable to each other (0.2 - 0.3ng/ml). However, two kits were of lower sensitivity (0.8-1.3ng/ml, and 2.4-2.5ng/ml, respectively). Two kits, produced by the same company, reacted with all of the nine HBsAg mutants, but five kits showed false-negative results with one or more of the HBsAg mutants. These data indicate that there are differences in the detection sensitivities for HBsAg and abilities to detect HBsAg mutants among commercially available HBsAg kits, which may explain false-negative clinical results.     

HIV抗体筛查试剂联合检测替代免疫印迹法的对比分析

目的探讨用两种不同厂家或原理的HIV抗体初筛试剂联合检测,以替代免疫印迹法(WB),用于检测某些高危人群或特殊人群。方法用包括快速检测和酶联免疫吸附试验(ELISA)试剂在内的9种HIV抗体筛查试剂,对200份样本进行联合检测,对任意一种试剂检测阳性的样本进行WB检测。结果ELISA初筛有阳性反应(S/CO值>1)的样本,WB确认阳性率为81.93%。初筛阳性且有1种ELISA试剂S/CO值>6的样本,WB确认阳性率为100%。两种快速试剂检测均为阳性反应的,WB确认阳性率为100%。结论可以用两次ELISA、两种快速试剂或一种快速试剂加一种ELISA试剂联合检测替代WB。     

Simultaneous triple point-of-care testing for HIV, syphilis and hepatitis B virus to prevent mother-to-child transmission in India

An innovative simultaneous triple point-of-care (STPOC) screening strategy for syphilis, hepatitis B and HIV with Determine(?) tests was offered to pregnant women presenting for antenatal care and evaluated for feasibility and preference in rural India. Of 1066 participants approached, 1046 consented, of which 1002 (96.0%) completed the strategy. Only 9% reported any history of testing in their current pregnancy. With STPOC screening, 989 women (98.7%) tested negative and 13 had preliminary positive results for infection. The total time taken was 45 minutes per participant. Mothers and infants were provided prophylaxis/treatment for HIV, syphilis and hepatitis B, with interventions initiated within 3-5 days. STPOC was preferred by 99.3% (95%CI: 98.8-99.8%) of participants, facilitated early simultaneous screening for the three infections, timely initiation of prophylaxis/treatment and was feasible in this rural setting. These data suggest that multiplexed STPOC screening for syphilis, hepatitis B and HIV in pregnancy would be desirable for women in rural India.     

1992～2000年血友病甲患者HBsAg、抗-HIV和梅毒阳性率调查分析

目的了解血友病甲患者乙型肝炎病毒(HBV)、艾滋病病毒(HIV)及梅毒的感染情况.方法对1992～2000年山东省血液中心血友病研究室确诊和治疗的162例血友病甲患者进行了HBsAg、丙氨酸氨基转移酶(ALT)、抗-HIV和梅毒抗体血清检测,并随机选择1 000例无偿献血者作为正常对照.结果 162例血友病甲患者HBsAg和ALT阳性率分别为4.32%(7/162)和8.64%(14/162),无偿献血者HBsAg和ALT阳性率分别为10.00%(100/1 000)和2.00%(20/1 000);血友病甲患者和无偿献血者抗-HIV和梅毒抗体阳性率均为零.结论血友病甲患者ALT阳性率高于无偿献血者(x2=21.65,P＜0.05),HBsAg阳性率低于无偿献血者(x2=6.72,P＜0.05),血友病甲患者和无偿献血者均无HIV和梅毒流行.     

Maternal syphilis infection is associated with increased risk of mother-to-child transmission of HIV in Malawi

OBJECTIVE: To determine the association between maternal syphilis and HIV mother-to-child transmission (MTCT). DESIGN: Prospective cohort study. METHODS: Pregnant women admitted at Queen Elizabeth Central Hospital (Malawi) in late third trimester were screened for HIV (by HIV rapid tests) and syphilis (by rapid plasma regain test and Treponema pallidum hemagglutination assay). HIV-infected women and their infants received nevirapine, according to the HIVNET 012 protocol. They were followed up at 6 and 12 weeks postpartum. Infant HIV infection was diagnosed by DNA PCR. FINDINGS: Of the 1155 HIV-infected women enrolled, 1147 had syphilis test results, of whom 92 (8.0%) were infected. Only 751 HIV-positive women delivered live singleton infants who were tested for HIV at birth. Of these, 65 (8.7%) were HIV-infected, suggesting in utero (IU) HIV MTCT. Of the 686 infants who were HIV-negative at birth, 507 were successfully followed up. Of these, 89 (17.6%) became HIV-infected, suggesting intrapartum/postpartum (IP/PP) HIV MTCT. Maternal syphilis was associated with IU HIV MTCT, after adjusting for maternal log10 HIV-1 viral load and low birth weight (LBW) [adjusted relative risk (ARR), 2.77; 95% CI, 1.40-5.46]. Furthermore, maternal syphilis was associated with IP/PP HIV MTCT (ARR, 2.74; 95% CI, 1.58-4.74), after adjusting for recent fever, breast infection, LBW and maternal log10 HIV-1 viral load. CONCLUSION: Maternal syphilis is associated with IU and IP/PP HIV MTCT. Screening and early treatment of maternal syphilis during pregnancy may reduce pediatric HIV infections.