引起HIV抗体不确定结果的非特异性反应影响因素分析

吴守丽; 高敏; 郑健; 颜苹苹; 严延生

Abstract

吴守丽,高敏,郑健,颜苹苹,严延生.引起HIV抗体不确定结果的非特异性反应影响因素分析[J].Chinese journal of Epidemiology,2018,39(9):1255-1260

引起HIV抗体不确定结果的非特异性反应影响因素分析

Analysis on influencing factors that leading to nonspecific responses to indeterminate results of HIV antibodies

Received:June 11, 2018

DOI：10.3760/cma.j.issn.0254-6450.2018.09.021

KeyWord: HIV抗体不确定非特异性反应影响因素

English Key Word: HIV antibody Indeterminate Nonspecific responses Influencing factor

FundProject:福建省卫计委中青年骨干人才培养项目（2015-ZQN-ZD-11）；福建省科技厅引导性项目（2016Y0010）

Author Name	Affiliation	E-mail
Wu Shouli	Institute for AIDS/STD Control and Prevention, Fujian Provincial Center for Disease Control and Prevention, Fuzhou 350001, China School of Public Health, Fujian Medical University, Fuzhou 350004, China Fujian Province Key Laboratory of Zoonosis Research, Fuzhou 350001, China
Gao Min	School of Public Health, Fujian Medical University, Fuzhou 350004, China
Zheng Jian	Institute for AIDS/STD Control and Prevention, Fujian Provincial Center for Disease Control and Prevention, Fuzhou 350001, China
Yan Pingping	Institute for AIDS/STD Control and Prevention, Fujian Provincial Center for Disease Control and Prevention, Fuzhou 350001, China Fujian Province Key Laboratory of Zoonosis Research, Fuzhou 350001, China
Yan Yansheng	Institute for AIDS/STD Control and Prevention, Fujian Provincial Center for Disease Control and Prevention, Fuzhou 350001, China School of Public Health, Fujian Medical University, Fuzhou 350004, China Fujian Province Key Laboratory of Zoonosis Research, Fuzhou 350001, China	yysh@fjcdc.com.cn

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Abstract:

目的分析引起HIV抗体不确定非特异性反应的相关影响因素，为HIV鉴别诊断及防治策略提供科学依据。方法采用病例对照研究设计，HIV抗体不确定组来源于2015－2016年福建省HIV确证实验室经免疫印迹试验（WB）确证结果为HIV抗体不确定且HIV核酸检测结果为阴性的样本，按照性别、年龄成组匹配同期福建省HIV抗体筛查样本，普通人群对照组来源于HIV抗体筛查结果阴性的普通人群样本，确证阴性对照组来源于HIV抗体初筛结果阳性但确证结果阴性的样本。应用ELISA法分别检测样本HBsAg、抗-HCV抗体、梅毒螺旋体（TP）抗体、抗核抗体（ANA）、人T淋细胞白血病病毒（HTLV）抗体和甲胎蛋白（AFP）含量。运用χ²检验和非条件多因素logistic回归分析引起HIV抗体不确定结果非特异性反应的影响因素。结果 HIV抗体不确定组样本110例，共出现13种WB带型模式，p24单条带最常见，占58.18%（64/110），gp160单条带和p17单条带分别占17.27%（19/110）和7.27%（8/110）。HIV抗体不确定组的TP抗体阳性率为10.91%（12/110），高于普通人群对照组的1.77%（4/226）和确证阴性对照组的3.64%（4/110），差异有统计学意义（χ²值分别为13.627和4.314，P<0.05）；AFP阳性率为18.18%（20/110）高于普通人群对照组的0.44%（1/226），差异有统计学意义（χ²=39.736，P<0.05），但与确认阴性对照组的23.64%（26/110）相比，差异无统计学意义（χ²=0.990，P>0.05）。ANA、HBsAg、抗-HCV抗体和HTLV抗体指标在HIV抗体不确定组与普通人群对照组间的差异无统计学意义。结论引起HIV抗体不确定结果非特异性反应的影响因素较为复杂，TP抗体阳性是HIV抗体不确定非特异性反应发生的可能影响因素。

English Abstract:

Objective To identify the influencing factors that leading to nonspecific responses to indeterminate HIV antibody tests, to provide scientific evidence for the differential diagnosis of HIV infection and control strategy. Methods A case control study was conducted. The samples of HIV antibody indeterminate in confirmed Western blot (WB) tests, but were negative in HIV nucleic acid tests, were collected as HIV antibody indeterminate group from WB results of HIV confirmatory laboratories of Fujian province in 2015-2016. The general population matched group with HIV antibody screening negative samples and WB negative matched group with WB negative samples were selected as the two compared groups by matching gender and age from HIV antibody screening in Fujian province in the same period. Blood concentrations of hepatitis B surface antigen (HBsAg), anti-hepatitis C virus (HCV) antibody, anti-treponema pallidum (TP) antibody, antinuclear antibody (ANA), anti-human T-cell leukemia virus (HTLV) antibody, and alpha-fetoprotein (AFP) were detected by using enzyme-linked immunosorbent assay (ELISA). χ² test and multivariate non-conditional logistic regression analysis were performed to identify the influencing factors that leading to nonspecific responses, to indeterminate HIV antibody tests. Results A total of 13 WB band patterns were observed in 110 HIV antibody indeterminate samples, in which a single p24 band (58.18%, 64/110), a single gp160 band (17.27%, 19/110) and a single p17 band (7.27%, 8/110) were the three most common patterns. The positive rate of anti-TP antibody was significantly higher in HIV antibody indeterminate samples than general population control group and WB negative control group (10.91%, 12/110 vs. 1.77%, 4/226 and 3.64%, 4/110), compared with two control groups (χ²=13.627 and 4.314, P<0.05). The positive rate of AFP was significantly higher in HIV antibody indeterminate samples than general population control group (18.18%, 20/110 vs. 0.44%, 1/226, χ²=39.736, P<0.05), the different was not significant compared with WB negative control group (18.18%, 20/110 vs. 23.64%, 26/110, χ²=0.990, P>0.05) While no significant differences were found between HIV antibody indeterminate group and two control groups in terms of the positive rates of ANA, HBsAg, anti-HCV antibody or anti-HTLV antibody. Conclusions The influencing factors that leading to nonspecific responses to indeterminate HIV antibody tests appeared complicate, and the anti-TP antibody positivity might be an influencing factor responsible for nonspecific responses to indeterminate HIV antibody tests.

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