HIV抗体确证试验假阳性1例分析

目的通过对1例艾滋病病毒（HIV）抗体确证试验阳性者进行随访检测,探讨目前HIV抗体筛查和确证检测技术存在的问题。方法对受检对象进行HIV抗体筛查和确证试验,并于3、6个月和1年随访检测。结果首次筛查试验PA试剂为阴性,第3代梅里埃ELISA试剂为阳性,确证试验WB试剂检测带型gp120p24,判为HIV-1抗体阳性。比较试验第4代梅里埃ELISA试剂为阳性,金豪、吉比爱ELISA试剂为阴性,雅培硒标试剂为弱阳性。病毒载量检测结果为阴性。3次随访检测,筛查试验结果与首次检测基本一致,确证试验带型分别为gp120p24、p24和p24p55,1年后的病毒载量检测结果为阴性,受检对象随访后结果定为阴性。4次血样集中检测显示,筛查试剂批间无明显差异,但不同试剂间有差异;确证WB试剂不同批号间带型存在差异。结论目前应用的WB确证试剂存在一定的批间差异,对弱阳性带型或阳性带型不常见的样本,需更换试剂批号重复进行确证检测;确证试验结果处于临界阳性状态者需进行流行病学史调查;WB确证试验若同时出现1条env带和p24带判为HIV抗体不确定,并进行随访。

Analysis of false positive-reaction in one case of HIV antibody confirmatory testing

Objective To explore the technical problems of the HIV-Ab test including screening and confirmatory tes ting following up a HIV-Ab positive case. Methods Antibody screening and confirmatory tests were carried out on the subject at 3, 6, 12 months. Results of the initiate testing, negative reaction occurred with PA（SFD HIV1/2） while positive reaction occurred with vironostika Ab-EIA. Thus the HIV-1 antibody was positive based on confirmatory test which showed the type of WB blet was gp120p24. Of the comparative testing, positive reaction also occurred with viro nostika Ag/Ab EIA while negative-reaction with kinghawk EIA and GBI EIA. In addition, Dainabot Determine（HIVl/2） met with a weak positive recation and the virus load was not detected. Of the 3 testings of follow-up, the screening testing met the same outcome of the initiate testing, the types of WB blet were gp120p24, p24 and p24p55 respectively, and virus-load of the last sample was not detected. Therefore the result of HIV 1 antibody negative was summed out. Of the total 4 tests, screening testing makes dfference among not the series but the brand of reagent, while confirmatory testing makes dfference among the series. Conclusion There is some difference among the series of reagent in the confirmatory testing, so that the comparative testing and re-testing should he carried out as the sample with weak or odd postive reaction is concerned. Epidemiology investigation should be carried out when the result turned to be critical; uncertainty of HIV-Ab happened when one env belt with p24 appeared at the same time by WB confirmatory test, and follow up the sub iect.