综合医院HIV抗体筛查阳性样本的分析

目的分析综合医院艾滋病病毒（HIV）抗体筛查阳性样本的特征。方法分别用中山、梅里埃、丽珠三种酶联免疫吸附试验（ELISA）试剂和雅培硒标试剂筛查HIV抗体，筛查阳性样本用蛋白印迹法（WB）进行确认。分析确认阳性、不确定、阴性三组样本的特征。结果2004年1月至2009年3月共检测HIV抗体192636例，其中阳性样本349例。确认阳性组174例，流行率0．090％；2006—2008年显著高于2004—2005年（Χ^2=11．35，P=0．001），以21～50岁的青壮年男性居多。ELISA试剂均为阳性，S／CO值为（12．89±3．14）；雅培试剂均为阳性；WB结果显示，91．38％HIV感染者呈现7条带以上。阳性一不确定组20例，ELISA试剂均为阳性，S／CO值为（4．90±3．40）；雅培试剂7例阳性；呈现p24带者18例（90．00％），gp160带7例（35．00％），gp120、p17带各1例（各5．00％），其余带未呈现。1例随访后转阳性，3例随访转阴性。阳性阴性组155例，心脏病人所占比例最高（26．45％）。ELISA试剂均为阳性，S／CO值为（2．63±2．54）；雅培试剂15例阳性。结论HIV感染人数逐年增加；筛查阳性样本中存在一定的不确定、假阳性结果，应按规定程序进行确认。

Analysis of the specimens with positive HIV antibody in screening tests from general hospitals

Objective To analyze the specimens with positive HIV antibody in screening tests from general hospitals. Methods From January 2004 to March 2009, three ELISA kits （Zhongshan, Biomerieux and Livzon） and a rapid test kit （Abbot Determine HIV-1/2 ） were used for screening HIV antibody. All repeatedly positive screening specimens were followed by WB assay. The three groups of specimens with positive, indeterminate and negative WB results were analyzed respectively. Results A total of 349 repeatedly positive specimens were obtained from 192 636 cases, with 174 positive, 20 indeterminate and 155 negative WB assay, HIV prevalence was 0. 090%, that in 2006 --2008 was signifieantly higher than in 2004--2005（Χ^2 =11.35, P =0.001）. The higher prevalence was observed among males aged 21--50 years. All the 174 samples were positive by ELISA （S/CO 12.89±3.14） and Abbot kits, of which 159（91. 38%） specimens showed more than 7 bands by WB assay. Of 20 positive--indeterminate specimens. all were positive by ELISA（S/CO：4.90±3.40） and 7 were positive by Abbot kit. The bands which were more commonly present in WB indeterminate specimens were p24（90.00%,18/20） and gp160（35.00%, 7/20） one turned to WB positive and three turned to WB negative during the follow--up. Among 155 positive--negative cases, subjects with heart disease had the highest proportion of 26.45%. All were positive by EL/SA （S/CO：2.63 ±2.54） and 15 were positive by Abbot kit. Conclusions The number of HIV-infected cases is increasing year after year. All HIV antibody screening positive cases should be confirmed by WB assay because of the existence of inde- terminate and false positive results.