HIV抗体快速检测在自愿咨询检测中的应用

目的在AIDS自愿咨询检测(voluntary counselling and testing,VCT)中应用快速检测,并与免疫印迹试验(western blotting,WB)结果比较,探讨进一步缩短确证时间及提高HIV感染者CD4+T淋巴细胞检测率的措施。方法用2种快速试剂进行筛查,对一阴一阳或双阳性样本进行WB确证检测,并比较和评价检测结果,同时采集患者血样行CD4+T淋巴细胞检测。结果 1435份样本中,1种或2种快速试剂检测结果为阳性有398份,经WB检测确证377份阳性,符合率94.7%;2种快速试剂检测结果均为阳性的有379份,WB检测确证376份阳性,符合率99.2%;2种快速试剂检测结果为阴性的有1037份,经PCR检测未发现HIV RNA阳性样本。结论在VCT及各种应急检测时,可用快速试剂进行筛查,然后WB确证,以缩短等待时间,提高CD4+T淋巴细胞检测率。同时为保证检测质量,以防漏检,推荐使用2种质量优良的快速试剂同时筛查。

Application of HIV antibody rapid test to voluntary counselling and testing

Objective To explore the way to further shorten the waiting time for confirmed results and improve the detection rate of CD4＋ T lymphocytes for HIV infections by applying HIV rapid test （RT） to voluntary counselling and testing （VCT）, and comparing the consistency of results between RT and western blotting （WB）. Methods Two reagents of RT were used for HIV screening, and WB was used for confirming test in positive samples found by one or two RT. The results were compared and evaluated. At the same time, blood samples were collected for the detection of CD4＋ T lymphocytes. Results Among 1435 samples, 398 were found positive by one or two RT reagents. Among these 398 samples, 377 were confirmed positive by WB, with a consistent rate of 94.7%;379 samples were found positive by two RT reagents, and 376 were confirmed positive by WB, with a consistent rate of 99.2%; 1037 samples were found negative by two RT reagents, and among them HIV RNA positive sample was not found by pooling PCR. Conclusions The strategy of RT used for HIV screening and WB used for confirming can be applied to VCT and other urgent tests, which can shorten the waiting time for confirmed results and improve the detection rate of CD4＋T lymphocytes for HIV infections. In addition, two RT reagents with high quality are suggested to be used together in HIV screening, so as to ensure test quality and avoid missing positives.