268份人类免疫缺陷病毒抗体待确定样本的检测结果分析

为了提高实验室人类免疫缺陷病毒(human immunodeficiency virus，HIV)抗体检测能力及对免疫蛋白印迹(Western blot，WB)实验结果的判断能力，对送检至北京市东城区艾滋病确证实验室的268份HIV抗体待确定样本进行确证实验及结果分析。按照试剂说明书和实验室标准作业程序(Standard Operation Procedure，SOP)操作对送检的全部样本进行WB确证实验；了解HIV筛查实验结果与确证实验结果的相关性，并分析不同送检机构、送检人群样本的检测结果差异以及不同试剂、不同检测方法的结果差异。结果显示在筛查出抗体待确定的268份样本中，确证阳性170份，阳性率63.43%；确证阴性51份，阴性率19.03%；不确定结果47份，占筛查有反应的17.54%。确证阳性病例来自监管场所、自愿咨询检测门诊(Voluntary Counseling and Test，VCT)和医疗机构，不同送检单位及不同人群的阳性样本率有显著统计学意义(P<0.01)。WB确证阳性样本带型以全条带和次全条带为主，且所有确证阳性标本均来自双试剂阳性样本。不同检测方法阳性样本率的差异有显著统计学意义(P<0.01)，其中化学发光法的样本阳性率占46.27%，酶联免疫吸附实验(ELISA)占88.29%，胶体硒法占43.48%。本研究结果提示，对潜在HIV感染者，应扩大检测面，加强医疗机构检测，并提供一种以上方法的多次检测，以减少漏检的风险。

Evaluation of 268 suspected human immunodeficiency virus serum samples by antibody-based assays

In order to improve the laboratory’s ability on antibody-based assays for human immunodeficiency virus (HIV) detection, a total of 268 serum samples which were positively detected by at least one of the current 3 primary antibody-based assays (chemiluminescence, ELISA and colloidal selenium) were subjected to standard western blot assay for HIV detection in the AIDS Confirmation Laboratory in Dongcheng District, Beijing. The results showed that among 268 samples to be identified, 170 were confirmed positive, with a positive rate of 63.43%. The negative rate of 51 confirmed cases was 19.03%. Inconclusive results accounted for 17.54% of screening responses. The results of this study suggest that for potential HIV infected persons, multiple testing with more than one method should be provided to reduce the risk of missed detection.