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。

Analysis of common patterns of HIV antibody banding by western blotting and its role in follow-up period

Objective To study the common patterns of human immunodeficiency virus(HIV) antibody by western blotting and its role in follow-up period. Methods A total of 460 HIV infection patients determined by western blotting and 16 HIV antibody indeterminant individuals were enrolled. The clinical data were analyzed retrospectively. Results Among the 460 HIV infection cases,the determination rates of HIV gp160,gp120 and gp41 in env antigen bands were 100.00%,99.35% and 96.30%,respectively. In pol antigen bands,the determination rates of HIV p66,p51 and p31 were 92.61%,86.96% and 91.96%,respectively. However,antibody reactivities to gag antigen varied,being 56.30%,13.26%,100.00% and 87.17% for p55,p39,p24 and p17,respectively. Totally,34 banding patterns were determined,and the most commonly observed patterns included gp160/gp120/p66/p55/p51/gp41/p31/p24/p17(absence of reactivity to p39,accounting for 41.74%),gp160/gp120/p66/p51/gp41/p31/p24/p17(absence of reactivity to p55 and p39,accounting for 23.70%) and all of the bands(accounting for 11.30%). Totally,16 HIV antibody indeterminant cases were followed up,and 4 HIV antibody indeterminant cases were converted to HIV antibody positive. The main source department of HIV infection was internal medicine department(66.31%) among the involved 28 clinical departments. Conclusions There are certain differences in the determination rate of western blotting bands among HIV infection patients. There are many departments with the first diagnosis of HIV infection. The medical institutions should pay attention to HIV determination and avoid the misdiagnosis and missed diagnosis of acquired immune deficiency syndrome(AIDS).