实时,普遍查急性艾滋病毒感染在例行艾滋病毒咨询和检测人口中的普遍查
Christopher D Pilcher1, J Todd McPherson, Peter A Leone
1Department of Medicien, University of North Carolina at Chapel Hill, Chapel Hill, NC 27599-7030, USA. cpilcher@med.unc.edu
JAMA
|July 4, 2002
概括
诊断急性人类免疫缺陷病毒 (HIV) 感染在大量实验室中是可行的,使用样本聚合和HIV RNA核酸测试. 这一战略加强了早期检测,改善了患者的治疗结果和公共卫生监测.
科学领域:
- 病毒学 病毒学
- 公共卫生 公共卫生
- 传染病诊断 传染病诊断 传染病诊断
背景情况:
- 人类急性免疫缺陷病毒 (HIV) 感染难以通过标准抗体测试来诊断,往往导致临床检测延迟.
- 核酸检测 (NAT) 艾滋病毒RNA用于查抗体阴性个体,特别是在献血者群体中.
研究的目的:
- 评估与HIV RNA逆转录酶-聚合酶链反应 (RT-PCR) 实施样本聚合的可行性,以检测在大量,低患病率环境中的急性和长期HIV感染.
- 在常规艾滋病毒检测服务中评估这种综合方法的诊断产量和效率.
主要方法:
- 在公共卫生病毒学实验室进行了临床诊断性能评估.
- 8505名接受常规艾滋病毒检测的人被前性地招募.
- 通过HIV酶免疫试验 (EIA) 呈阴性血清样本在池中使用超敏感的HIVRNART-PCR测试进行选,并对阳性池进行确认测试.
主要成果:
- 该研究在8194名符合条件的个人中发现了39例长期艾滋病毒感染病例和4例急性艾滋病毒感染病例.
- 急性艾滋病毒感染的患病率为每10,000人中有4.9,所有四个病例都发生在女性中.
- 实施的战略需要147个HIVRNA测试,并显示出高的整体特异性 (0.9999).
结论:
- 广泛诊断急性艾滋病毒感染是可行的例行测试群体通过样本集结和核酸测试.
- 这种方法可以显著提高诊断产量,相比单独传统的HIV抗体检测.
- 这些发现支持将NAT与加强艾滋病毒检测和早期干预的策略进行整合.
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