在常规HIV-1检测失败的情况下,在传染性窗口期内,涉及在血组转换前的血液成分传播的病例
A E Ling1, K E Robbins, T M Brown
11600 Clifton Rd NE, Mailstop G-19, Atlanta, GA 30333. KRobbins@cdc.gov
JAMA
|July 13, 2000
概括
人类免疫缺陷病毒 (HIV) 在感染窗口期间从抗原和抗体阴性捐赠者传播. 目前的美国小池核酸放大测试 (NAT) 可能会错过献血中的低水平病毒病.
科学领域:
- 病毒学 病毒学
- 传染性疾病 传染性疾病
- 公共卫生 公共卫生
背景情况:
- 目前的血液查有效地减少了人类免疫缺陷病毒 (HIV) 的传播.
- 然而,在血清转化前窗口期间的捐赠可以逃避抗原和抗体测试.
- 核酸放大测试 (NAT) 正在实施,但单个与迷你池选仍在争论中.
研究的目的:
- 确定一个捐赠者和两个接受者之间的HIV-1遗传联系.
- 使用拟议的美国NAT查试验,评估供体血对HIV的检测.
- 评估单个与迷你池NAT查的敏感性.
主要方法:
- 在新加坡的案例研究 (1997年10月).
- 对HIV-1口腔和内膜区域的基因分析.
- 通过定性/定量HIV NAT测定来测试供体血.
主要成果:
- 在捐赠者和接受者中发现相同的HIV-1亚型E序列.
- 捐赠者有低水平的病毒血 (5-39副本/毫升).
- 在未稀释的血中始终检测到HIVRNA;在迷你池稀释中不一致 (1:16, 1:24).
结论:
- 艾滋病毒的传播发生在感染窗口期间.
- 捐赠者的病毒载量估计低于40副本/毫升.
- 美国小游泳池HIV NAT协议可能缺乏对窗口期捐赠的敏感性.
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