HIV抗体初筛阳性结果与确证试验结果比较
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摘要
目的分析艾滋病病毒(HIV)初筛试验阳性结果与确证试验结果的符合性,探讨造成初筛假阳性的因素。方法对1 012例HIV初筛阳性样本用免疫印迹试验(WB)进行确证试验,将初筛检测结果按年龄分布、检测方法、S/CO值与WB检测结果进行比对分析。结果 1 012份初筛阳性样本的总体确证阳性率为37.6%(381/1 012),女性(6.9%)确证阳性率明显低于男性(53.8%),60岁以上人群确证阳性率为15.2%,显著低于其它年龄组。初筛试验不同检测方法之间的确证阳性率差异明显,发光法最低,为32.6%,快速法最高,为85.1%。发光法S/CO值<5的确证阳性率仅为1.1%。结论初筛假阳性偏高一方面与特定人群有一定关系,同时受检测方法影响较大,发光法的广泛应用是造成假阳性升高的重要原因,发光法检测低值大部分为假阳性。
Objective To analyze the consistency between the results of human immunodeficiency virus(HIV) screening test and confirmatory test results and to explore factors associated with false positive in screening test. Methods A total of 1 012 cases of HIV antibody positive in screening test were confirmed with Western blot(WB). The results of WB were compared with those of screening test according to the age distribution, test method and signal to cut-off(S/CO) value. Results The confirmed positive rate for all the samples was 37.6%(381/1 012). The confirmed positive rate for the female cases(6.9%)was much lower than that of the male cases(53.8%) and the positive rate of the cases over 60 years old was 15.2%,significantly lower than that of the cases of other ages. The positive rate of confirmatory test differed significantly by detection methods in the screening test, with the lowest for those with luminescence method(32.6%) and the highest with rapid method(85.1%). The confirmatory positive rate was only 1.1% for the results with the S/CO value of < 5 by luminescence method. Conclusion The high false positive rate in initial screening is related to specific examinees and is greatly affected by detection method. The extensive application of luminescence method is an important reason for the increase of false positive, and low value results of the luminescence method are mostly false positive.
Objective To analyze the consistency between the results of human immunodeficiency virus(HIV) screening test and confirmatory test results and to explore factors associated with false positive in screening test. Methods A total of 1 012 cases of HIV antibody positive in screening test were confirmed with Western blot(WB). The results of WB were compared with those of screening test according to the age distribution, test method and signal to cut-off(S/CO) value. Results The confirmed positive rate for all the samples was 37.6%(381/1 012). The confirmed positive rate for the female cases(6.9%)was much lower than that of the male cases(53.8%) and the positive rate of the cases over 60 years old was 15.2%,significantly lower than that of the cases of other ages. The positive rate of confirmatory test differed significantly by detection methods in the screening test, with the lowest for those with luminescence method(32.6%) and the highest with rapid method(85.1%). The confirmatory positive rate was only 1.1% for the results with the S/CO value of < 5 by luminescence method. Conclusion The high false positive rate in initial screening is related to specific examinees and is greatly affected by detection method. The extensive application of luminescence method is an important reason for the increase of false positive, and low value results of the luminescence method are mostly false positive.
引文
[1]中国疾病预防控制中心.全国艾滋病检测技术规范(2015年修订版)[S].北京:国家标准出版社,2015.
[2]杨扬,郑海潮,于彤彤,等.746例HIV初筛阳性者确证结果的对比分析[J].热带医学杂志,2016,16(3):329-331.
[3]杨东智,曹慜,吴忠兰,等.宁夏2016年HIV抗体筛查阳性样本确证结果分析[J].中国卫生检验杂志,2017,27(13):1888-1891.
[4]尤佳女,许珂,张兴亮,等.杭州市HIV感染待确定样本检测结果分析[J].中国卫生检验杂志,2018,28(15):1856-1858.
[5]杨洋,白梅,张振,等.锦州市2014-2016年HIV抗体筛查阳性样本确证实验结果分析[J].中国卫生检验杂志,2017,27(15):2162-2163,2169.
[6]梁彩云,高凯,韩志刚,等.广州市808例HIV抗体筛查阳性孕产妇复核和确证结果分析[J].华南预防医学,2015,14(2):155-157.
[7]朱厚宏,王晨笛,刘杨,等.孕产妇HIV抗体筛查阳性与免疫印迹试验对比[J].预防医学情报杂志,2011,27(2):154-156.
[8]陈苏苏,陈蕾,吴越人,等.HIV血清抗体免疫学检测结果分析[J].检验医学与临床,2017,14(6):832-833.
[9]吴春磊,李婧,邓安彦,等.ELISA法和化学发光法在感染性免疫检查中的比较分析[J].国际检验医学杂志,2017,38(16):2302-2304.
[10]Kim S,Lee JH,Choi JY,et al.False-positive rate of a"fourthgeneration"HIV antigen/antibody combination assay in an area of low HIV prevalence[J].Clin Vaccine Immunol,2010,17(10):1642-1644.
[11]张晓红,张倩,周学红,等.雅培化学发光法在HIV筛查试验中假阳性分析[J].标记免疫分析与临床,2013,20(1):43-46.
[12]罗娜,张劲丰,苏荣,等.雅培化学发光法检测HIV的S/CO比值与确证试验的相关性分析[J].中国卫生检验杂志,2017,27(19):2794-2796.
[2]杨扬,郑海潮,于彤彤,等.746例HIV初筛阳性者确证结果的对比分析[J].热带医学杂志,2016,16(3):329-331.
[3]杨东智,曹慜,吴忠兰,等.宁夏2016年HIV抗体筛查阳性样本确证结果分析[J].中国卫生检验杂志,2017,27(13):1888-1891.
[4]尤佳女,许珂,张兴亮,等.杭州市HIV感染待确定样本检测结果分析[J].中国卫生检验杂志,2018,28(15):1856-1858.
[5]杨洋,白梅,张振,等.锦州市2014-2016年HIV抗体筛查阳性样本确证实验结果分析[J].中国卫生检验杂志,2017,27(15):2162-2163,2169.
[6]梁彩云,高凯,韩志刚,等.广州市808例HIV抗体筛查阳性孕产妇复核和确证结果分析[J].华南预防医学,2015,14(2):155-157.
[7]朱厚宏,王晨笛,刘杨,等.孕产妇HIV抗体筛查阳性与免疫印迹试验对比[J].预防医学情报杂志,2011,27(2):154-156.
[8]陈苏苏,陈蕾,吴越人,等.HIV血清抗体免疫学检测结果分析[J].检验医学与临床,2017,14(6):832-833.
[9]吴春磊,李婧,邓安彦,等.ELISA法和化学发光法在感染性免疫检查中的比较分析[J].国际检验医学杂志,2017,38(16):2302-2304.
[10]Kim S,Lee JH,Choi JY,et al.False-positive rate of a"fourthgeneration"HIV antigen/antibody combination assay in an area of low HIV prevalence[J].Clin Vaccine Immunol,2010,17(10):1642-1644.
[11]张晓红,张倩,周学红,等.雅培化学发光法在HIV筛查试验中假阳性分析[J].标记免疫分析与临床,2013,20(1):43-46.
[12]罗娜,张劲丰,苏荣,等.雅培化学发光法检测HIV的S/CO比值与确证试验的相关性分析[J].中国卫生检验杂志,2017,27(19):2794-2796.
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