单人份核酸检测在降低输血感染人类免疫缺陷病毒残余风险中的应用

目的 分析单人份核酸检测技术(individual donor-nucleic acid amplification test,ID-NAT)对窗口期人类免疫缺陷病毒(HIV)阳性标本的检出能力,探讨ID-NAT对降低输血感染HIV残余风险的作用.方法 采用Procleix Tigris单人份核酸检测系统和两种不同厂家的ELISA试剂对采集的血液标本进行平行检测,对ELISA检测阴性ID-NAT检测阳性标本进行HIV鉴别试验,并对HIV鉴别阳性的献血者进行追踪检测.结果 采集血液标本196900份,检出ELISA阴性ID-NAT联检阳性标本256例,HIV鉴别实验阳性标本2例.第1例HIV阳性献血者献血后29 d免疫印迹确证试验为HIV-1抗体阳性,且HIV(1+2)抗体及HIV-1 P24抗原ELISA双试剂检测均呈阳性反应.第2例HIV阳性献血者,献血后第0、4、7 d血液标本病毒载量呈上升趋势,第4天仅单试剂ELISA检测呈阳性反应,第7天和第14天时,双试剂ELISA检测已均呈阳性反应,且第30天确证试验为HIV-1抗体阳性.结论 ID-NAT应用于血液筛查可缩短HIV检测窗口期,降低输血感染HIV残余风险,从而有效提高血液安全性.

Application of Individual Donor-nucleic Acid Amplification Test in Reducing Residual Risk of Transfusion-trans-missible HIV Infection

Objective To analyze detection capability of individual donor-nucleic acid amplification test ( ID-NAT) for HIV-positive blood samples during window period and to investigate effect of ID-NAT in reducing residual risk of transfusion-transmissible human immunoddficiency virus ( HIV) infection. Methods Blood samples were performed parallel detection by ID-NAT ( Procleix Tigris) and two kinds of enzyme linked immunosorbent assay ( ELISA) reagents from different manufactories, and then the samples with negative by ELISA detection and positive by ID-NAT detection were tested by HIV identification assay. The blood donors with positive HIV identification assay were made tracing tests. Results A total of 196900 blood samples were collected, in which 256 samples were negative by ELISA detection and positive by ID-NAT combined detection, and 2 samples were positive by HIV identification assay. The first HIV-positive blood donor was confirmed positive HIV-1 antibody 29 d after blood donation by western blot confirmatory test, and posi-tive HIV(1+2) antibody and HIV-1 P24 antigen were found by two kinds of ELISA reagents detection. Blood sample of another HIV-positive blood donor showed a elevation trend in virus load 0, 4 and 7 d after blood donation;only one kind of ELISA reagent detection was positive 4 d after blood donation, but both of two kinds of ELISA reagents detection were positive 7 and 14 d after blood donation, and positive HIV-1 antibody was confirmed 30 d after blood donation. Conclu-sion The application of ID-NAT in blood screening can shorten window period of HIV detection and reduce residual risk of transfusion-transmissible HIV infection, and then blood safety can be effectively improved.