Screening test results and epidemiological characteristics of people infected with human immunodeficiency virus in the window period confirmed by Western blotting as "negative"
10.3760/cma.j.cn311365-20230910-00075
- VernacularTitle:蛋白质印迹法确证为"阴性"的窗口期人类免疫缺陷病毒感染者的筛查试验结果及流行病学特征
- Author:
Yan TANG
1
;
Zhenhua SHEN
;
Rong SUN
;
Jingjing LANG
;
Yong ZHANG
;
Bing ZHAO
Author Information
1. 上海市浦东新区疾病预防控制中心微生物检验科，上海 200136
- Keywords:
Fourth-generation chemiluminescent assay;
Fourth-generation enzyme-linked immunosorbent assay;
Fourth-generation rapid diagnostic test
- From:
Chinese Journal of Infectious Diseases
2024;42(3):176-180
- CountryChina
- Language:Chinese
-
Abstract:
Objective:To analyze the screening test results of people infected with human immunodeficiency virus (HIV) in the window period confirmed to be "negative" by Western blotting, with a view to finding a way to identify people infected with HIV during the window period as soon as possible.Methods:In the serum (plasma) samples of HIV-positive people screened by the fourth-generation chemiluminescent immunoassay in medical institutions at all levels in Pudong New District, Shanghai from 2014 to 2021, a total of 100 people (200 samples) were confirmed as "negative" and the fourth-generation enzyme-linked immunosorbent assay was screened positive. According to the follow-up results, it was divided into the early infection group (24 cases) and the uninfected group (76 people), and the fourth-generation rapid diagnostic test (RDT) was performed. The compliance rates of positive results of screening and follow-up were compared, and the epidemiological data of early HIV infections were analyzed. The chi-square test was used for statistical analysis.Results:Of the 200 samples, 48(24.00%) were early infected. A total of 106 samples antigens and (or) antibodies were positive by the fourth-generation RDT screening, and the compliance rate with the follow-up results was 45.28%(48/106), of which those of the fourth-generation RDT screening antigen positive and follow-up results were 100.00%(36/36), which was higher than the antibody positive results (24.68%(19/77)). The difference was statistically significant ( χ2=57.49, P<0.001). Of the 24 cases of early HIV infections, 19(79.2%) had acute symptoms. Only one out of six people≥50 years old had asked about the partner about his HIV status before engaging high-risk sex, and 13 out of 18 people <50 years old had asked the partners about their HIV status or to detect HIV before engaging high-risk sex. The difference was statistically significant ( χ2=5.71, P=0.017). Out of the six people ≥50 years old, only one actively tested HIV, and 12 out of 18 people <50 years old actively tested HIV, and the difference was statistically significant ( χ2=4.53, P=0.033). Conclusions:The Western blotting confirmed "negative" samples may be false negative. The comprehensive evaluation which combined with the fourth-generation screening test could help to screen out HIV window infection. In addition, the publicity, education and monitoring of high-risk population need to be further strengthened.
