梅毒血清学检测作为HIV替代检测指标的应用价值评估

发布时间：2018-01-25 18:38

本文关键词： 梅毒血清学检测 HIV发生率确证试验替代指标　出处：《中国输血杂志》2015年02期 　论文类型：期刊论文

【摘要】：目的评估梅毒血清学检测在大连血液中心献血者筛查中作为HIV替代检测指标的应用价值。方法统计2008年1月1日-2013年6月30日间大连市血液中心的血液检测数据,按献血者年龄、性别、类别和时间段分别比较不同献血人群的TP和HIV的流行率,估算通过梅毒血清学检测排除的HIV窗口期感染的频率。结果共有321973份血液标本数据纳入统计分析,确认梅毒抗体阳性献血者1393例、确认HIV抗体阳性献血者58例,梅毒与HIV合并感染仅4例。大连地区献血者中梅毒和HIV的流行特征存在明显的年龄、性别、献血者类别及变化趋势的差异。梅毒血清学阳性的血液检出HIV阳性频率显著高于梅毒血清学阴性的血液(P0.05),但对HIV的检出只有较低的敏感度(7.69%)和阳性预期值(0.21%)。HIVRNA检测的实施进一步降低了梅毒血清学检测对献血者HIV感染检出的敏感度。研究期内,梅毒血清学检测对HIV窗口期的排除率仅为6.5×10-7。结论在本中心现有的HIV抗体和HIVRNA联合检测条件下,梅毒血清学检测作为大连地区献血者HIV替代检测指标的应用价值极小。
[Abstract]:Objective to evaluate the value of syphilis serological examination in screening blood donors in Dalian Blood Center as a substitute for HIV. Methods Blood samples were collected from January 1st 2008 to June 30th 2013 in Dalian City. Blood test data from the fluid center. The prevalence rates of TP and HIV in different blood donors were compared according to age, sex, type and time period of blood donors. The frequency of HIV window infection excluded by syphilis serological examination was estimated. Results A total of 321973 blood samples were included in the statistical analysis and 1393 blood donors were confirmed to be positive for syphilis antibody. 58 cases of HIV antibody positive blood donors and 4 cases of syphilis and HIV co-infection were confirmed. The prevalence characteristics of syphilis and HIV in blood donors in Dalian area were obvious in age and sex. The positive frequency of HIV in syphilis seropositive blood was significantly higher than that in syphilis seropositive blood (P0.05). But there was only a lower sensitivity for HIV detection (7.69) and a positive expected value of 0.21). HIV RNA testing further reduces the sensitivity of syphilis serological tests to the detection of HIV infection in blood donors. The exclusion rate of syphilis serological examination for HIV window period was only 6.5 脳 10 ~ (-7). Conclusion under the existing condition of HIV antibody and HIVRNA in our center. The application value of syphilis serological test as a substitute index of HIV for blood donors in Dalian area is very small.
【作者单位】：大连市血液中心;大连医科大学检验学院;
【分类号】：R512.91
【正文快照】： 梅毒血清学检测是最早纳入血液筛查的传染病检测项目,至今已有70余年历史。尽管近几十年来国内外鲜有输血后梅毒的报道,但该检测仍然被保留的重要原因之一就是作为HIV的替代检测指标防范HIV的窗口期感染[1]。但是,随着HIV检测方法的发现及改进,特别是核酸检测技术的应用,梅毒

【参考文献】