HIV抗体检测替代策略Ⅰ在广州市应用的可行性研究

目的探讨艾滋病病毒（HIV）抗体检测替代策略Ⅰ（初筛用硒标快速试剂,复测用金标快速试剂和梅里埃酶联免疫吸附试验试剂）,在广州市各类人群中应用的可行性。方法收集广州市各类人群,包括自愿咨询检测（VCT）者、静脉吸毒者（IDU）、商业性性工作者（CSW）和男男性行为者（MSM）的样本,同时用替代策略Ⅰ和“初筛检测＋蛋白印迹法（WB）”检测,并对检测结果进行比较。结果共收集检测了2 133份样本,两种检测策略的总体阳性符合率为95.52%,其中VCT人群阳性符合率为93.88%,低于其他三类人群的阳性符合率（100%）（P〈0.05）;总体阴性符合率为99.9%。“初筛检测＋WB”检测结果为阳性的样本,替代策略I100%判断为阳性,未发生漏检漏报。替代策略I检测结果为“HIV抗体不确定”样本的数量,是相应“初筛检测＋WB”的16.67%（6/36）,差异有统计学意义（P〈0.05）。结论替代策略Ⅰ在广州市的应用基本是可行的,尤其是对IDU、CSW和MSM高危人群,在普通人群如VCT中的应用要谨慎。

Evaluation of feasibility of alternative strategy I for HIV antibody testing in Guangzhou

Objective To evaluate the reliability of alternative strategy I for testing HIV antibody and discuss the feasibility of adopting this strategy in different population groups in Guangzhou. Methods Blood samples of visitors to VCT clinics, IDUs, CSWs and MSM were collected. Western Blot plus ELISA and alternative strategy I were simultaneously applied to detect all the samples, and the results of these two methods were compared. Results Of the 2 133 collected samples, the positive consistent rate between the two methods was 95.52%, the positive consistent rate in visitors to VCT clinics （93.88 % ） was lower than that in IDUs, CSWs and MSM（100%）（P〈 0.05） ; the negative consistent rate was 99.9% . All the samples confirmed as positive by WB plus ELISA were found 100% positive by alternative strategy I, and there was no false negative. The number of indeterminate samples by alternative strategy I accounted for 16.67% of those by WB plus ELISA （6/36）, and the difference had statistic significance. Conclusion Alternative strategy I is generally applicable in Guangzhou, especially for the high risk population, such as IDUs, CSWs and MSM, but it should be applied with caution in visitors to VCT clinics and the general population.