核酸定量检测试验应用于HIV-1感染实验室诊断的探讨

目的:探讨核酸定量检测在HIV-1感染实验室诊断中的应用。方法:选取145例第四代抗原/抗体联合诊断筛查试验为阳性反应的血浆样本,分别用Western印迹和HIV-1核酸定量方法进行检测,综合对比分析2种方法检测结果。结果:Western印迹检出阳性样本120例,不确定样本17例,阴性样本8例;HIV-1核酸定量试验检出结果大于检测限样本131例,其中包括12例Western印迹不确定样本、2例Western印迹阴性样本;有3例Western印迹阳性样本用HIV-1核酸定量检测试验未能检出。结论:核酸定量检测试验对于HIV-1感染阳性样本是一种有效的实验室诊断方法;对HIV-1核酸定量检测结果为"TND"的样本,建议加做Western印迹或结合其他补充试验结果进行综合诊断。     

用蛋白印迹确认实验检查"人类免疫缺陷病毒抗体不确定"结果的分析

目的 探讨蛋白印迹实验(WB)“人类免疫缺陷病毒(HIV)抗体不确定”结果的特点、产生的原因、WB确认实验存在的问题及可能的改善措施。方法 归纳分析本实验室2004～2005年的WB检测结果为“HIV抗体不确定”者的人群分布特点、实验检测特点、受检者随访复检及抗体转归情况。结果 “HIV抗体不确定”者人员构成中相对健康的自愿咨询检测者、献血员以及孕产妇占50%,“HIV抗体不确定”者随访困难、复检率较低;WB实验存在假阳性、尤以P24带较为严重。结论 “HIV抗体不确定”结果与WB实验的假阳性有关,实验室应采取应对措施尽可能减少“HIV抗体不确定”及对结果进行准确解释。     

Evaluation of the Bio-Rad Geenius HIV 1/2 Confirmation Assay as an Alternative to Western Blot in the Korean Population: A Multi-Center Study

Recently updated recommendations for diagnosis of HIV infection suggest a new diagnostic algorithm including HIV-1/HIV-2 antibody differentiation immunoassay instead of western blot (WB) as a confirmatory testing. We evaluated Bio-Rad Geenius HIV1/2 confirmation assay as a simple and reliable alternative to WB in the Korean population with low HIV prevalence. The Geenius HIV1/2 was performed in a total of 192 serum specimens (140 reactive and 52 nonreactive specimens by ARCHITECT HIV Ag/Ab Combo assay) that were prospectively collected from five institutions. HIV-1 nucleic acid amplification test (NAT) was performed in negative or indeterminate specimens by Geenius HIV1/2 or WB. Among 140 reactive specimens by HIV Ag/Ab assay, 82 (58.6%) were positive for HIV-1 Ab by Geenius HIV1/2. Among 58 negative or indeterminate specimens by Geenius HIV1/2, four specimens (6.9%) were positive by HIV-1 NAT. The sensitivity and specificity of Geenius HIV1/2 were 95.3% and 100.0%, respectively. When we considered only WB, the sensitivity and specificity of Geenius HIV1/2 were 100.0% and 99.1%, respectively. Agreement between Geenius HIV1/2 and WB was excellent (weighted Kappa = 0.89). The Geenius HIV1/2 is simple and time-saving compared with WB. It has an excellent performance and can be a reliable alternative to WB. HIV-1 NAT should be performed in negative or indeterminate specimens by Geenius HIV1/2 to detect acute HIV infection as recommended in new HIV testing algorithms.     

一种简易的免疫PCR方法的建立

免疫PCR为一种高敏感度检测抗原的新技术,操作程序大多沿袭ELISA方法.用戊二醛作连接剂,将蛋白质高效率包被在普通PCR管内壁,使免疫及PCR反应用普通PCR仪得以在管中连贯地进行.实验结果表明,标准曲线的线性关系好,与ELISA方法比较敏感度高出约10⁵.这一改良法的建立,可望促进免疫PCR的普及应用.     

免疫印迹法在实验大鼠汉坦病毒监测中的应用及与间接免疫荧光法之比较

用汉坦病毒汉滩株（７６－１１８）重组核蛋白作为免疫印迹法（ＷｅｓｔｅｒｎＢｌｏｔ以下简称ＷＢ）的诊断抗原,用于实验感染大鼠血清抗体效价测定。同时与用汉城株（ＳＲ－１１）感染的Ｖｅｒｏ－Ｅ６细胞作抗原的间接免疫荧光法（以下简称ＩＦＡ）进行比较。ＷＢ法对３／４标本在大鼠接种病毒后第３天测得血清ＩｇＭ阳性,而ＩＦＡ法仅１／４标本出现阳性,ＩＦＡ效价为１：５１２０的血清,ＷＢ效价为１’：４０９６０,且在血清１：１０稀释时反应带亦清晰。两种方法分别测定６４份大鼠血清。甩ＩＦＡ法,４４份（６８．８％）出现类似阳性的荧光颗粒,而用ＷＢ法测定,无特异的反应带出现。非感染Ｖｅｒｏ－Ｅ６细胞作ＩＦＡ抗原,３０份（４６．９％）与正常细胞抗原有反应,此结果表明ＷＢ法在特异性和敏感性方面均高于ＩＦＡ法。ＩＦＡ法中的非特异性反应系血清与细胞成份之反应。     

Prevalence of HIV Indeterminate Western Blot Tests and Follow-up of HIV Antibody Sero-Conversion in Southeastern China

HIV-indeterminate Western blotting(WB) results are typically obtained in WB confirmatory assays, and the number of indeterminate samples may increase with the detection of HIV infections, which will present considerable challenges for the management of HIV/AIDS. Nucleic acid detection has been used as a laboratory test for screening suspected or indeterminate samples. However, the effectiveness of these assays for the differential diagnosis of HIV-indeterminate WB samples remained undetermined. In this study, 210 subjects with HIV-indeterminate WB results were detected from 6360 positive HIV screening samples between 2015 and 2016 in southeastern China, in which HIV-indeterminate WB results accounted for 3.30%. The highest proportion of indeterminate results was observed in pregnant and lying-in women receiving physical examinations(16.67%), followed by that in voluntary blood donors(8.82%). The most common WB band patterns were p24, gp160 and p24, and gp160. The follow-up study revealed that the highest negative and positive conversion rates of HIV antibodies were in samples with a single p24 band(80.28%), and with gp160 and p24 bands(86.21%), respectively. Among the Env, Gag, and Pol antibodies, samples with a Gag band showed the highest negative conversion rate(81.25%), whereas the highest positive conversion rate was observed in samples with an Env band(56.76%). In addition, quantitative and qualitative HIV nucleic acid testing exhibited the highest sensitivity(96.3%) and specificity(97.85%), respectively. Our results indicate a lower proportion of HIV indeterminate WB results in southeastern China compared to previous reports, and the follow-up re-examination of patients with HIV indeterminate results should be performed. Nucleic acid testing facilitates the identification of HIV infections.     

Replication of human immunodeficiency virus in two T-cell lines and their application as antigens for immunofluorescence

Two T-cell lines, TALL-1 and CCRF-CEM, were infected with human immunodeficiency virus (HIV), strain LAV, to explore the time course of the appearance of various virus specific antigens, and to establish an antibody assay system by indirect immunofluorescence (IF). These cells were infected with LAV at two different input multiplicity of infection (MOI). Antigens were tested by Western blot analysis (WB) and IF. Antigens for WB were extracted from the infected cells at various times after infection, but pooled sera of American HIV carriers could not recognize gp41 or gp160. Antigen expression was highest in CCRF-CEM, but, as the antigen for IF, TALL-1 infected at the MOI of 8.0 was the most suitable 7 days after infection, because it includes a fairly large number of uninfected cells, which served as the internal control.     

DEVELOPMENT AND EVALUATION OF A RAPID ENZYME-LINKED IMMUNOFILTRATION ASSAY (ELIFA) AND AN ENZYME-LINKED IMMUNOSORBENT ASSAY (ELISA) FOR THE DETECTION OF STAPHYLOCOCCAL ENTEROTOXIN B

An enzyme-linked immunofiltration assay (ELIFA) and a microtitre plate enzyme-linked immunosorbent assay (ELISA) were developed and compared for their ability to detect staphylococcal enterotoxin B (SEB). The double antibody capture format was used for both assays. Factors which improved the sensitivity of the ELIFA system were (1) addition of casein and thimerosal to the antigen dilution buffer; (2) addition of polyethylene glycol (MW 6000) to the detection and conjugate antibody dilution buffers; and (3) washing with diethanolamine buffer prior to addition of the substrate/chromogen. The ELIFA system had a turnaround time of approximately 1 h and a detection limit of 1 ng/mL of purified SEB. The ELISA had a total turnaround time of 21 h, or 3 h using plates pre-coated overnight with the capture antibody. The detection limit of the ELISA for purified SEB was 0.05 ng/mL. The detection limit of SEB in cheese samples spiked with purified enterotoxin and subjected to a simple extraction procedure was 1 ng/mL and 0.1 ng/mL of extract, with the ELIFA and the ELISA, respectively.     

HIV感染早期病毒p24蛋白的检测

目的:建立敏感、特异的检测血清中HIV-p24蛋白的方法,作为HIV感染早期即窗口期的监测手段。方法:用纯化的p24蛋白免疫小鼠及家兔,获得单克隆及多克隆抗体,经DEAE-52阴离子交换柱纯化后,标记辣根过氧化物酶,建立ELISA双抗体夹心及间接双抗体夹心方法,检测HIV-p24蛋白。结果:包被单抗、标记多抗或包被多抗、标记单抗,均能特异地检出系列稀释的p24蛋白,包被混合单抗较包被多抗更敏感;经标记的抗种属抗体放大可明显提高检测的敏感性。结论:建立了敏感、特异的检测p24蛋白的双抗体夹心法,间接放大方法可检出50pg/mL的HIV-p24蛋白,检测敏感性与国际同类产品相似。     

免疫荧光检测HIV—1抗体方法的建立和应用

免疫荧光法检测HIV抗体是确认HIV感染的方法之一［l］,与蛋白印迹法相比,它的特异性更高,易于鉴别非特异反应,更为经济、快速、容易操作。为了拥有更多的HIV抗体检测手段,我们用感染和未感染HIV－l的HeLaCD“细胞制备抗原片,建立了免疫荧光检测HIV抗体的方法,并进行了初步应用。材料和方法1细胞和病毒HeLaCD4”细胞,引自美国BruceChesebro博士的实验室,用含10％热灭活小牛血清的RPMI1640培养基培养和传代。HIV－l株引自美国。2血清艾滋诊断试剂国家参比品,批号9602Z16份经蛋白印迹确认的HIV抗体阳性血清;10份健康…