摘要
目的研究人类免疫缺陷病毒(HIV)/丙型肝炎病毒(HCV)共感染对两种病毒感染实验室诊断的影响。方法对300例经免疫印迹试验(WB)确认的HIV感染者,以酶免疫测定HCV抗体,测定CD4/CD8计数;其中197例测定病毒载量,逆转录聚合酶链反应检测HCV核酸,阳性样品限制性片段长度分析丙肝分型,比较共感染和非共感染组在各检测诊断指标的差别。结果HCV诊断HCV抗体阴性组中19.5%为核酸阳性。多元回归分析,HCV核酸阳性,1b+2a混合感染,1b基因型的感染3个因素对HCVEIA检测的S/CO值的升高有独立的显著影响。HIV诊断300例,共感染组和非共感染组HIVELISAA<3的样本比例分别为4/265,5/41,有P<0.01的差异有统计学意义;A>3的样品中CD4分组后按比例取77份比较WB条带,共感染组P55条带出现率显著高于非共感染组(16/30,12/47,P<0.01)。结论HIV免疫抑制可造成很高的HCV抗体假阴性率,该人群推荐HCV核酸定性检测。共感染对HIVELISA检测的影响表现为强阳性比例的显著提高;对HIVWB各主要诊断条带未见影响,共感染组p55条带比例显著高可能提示病毒间免疫和分子水平相互作用。对HCVEIA3的S/CO值有独立影响的因素包括HCV核酸阳性,1b+2a混合感染,1b基因型。
Objective To investigate the mutual effect of HIV/HCV Co-infection on the ir testing or diagnosis. Methods The 300 participants of HIV infection were confirmed WB. All of them were tested for HCV antibody by EIA and CD4/CD8 count by cytoflowmetry; A subgroup of 197 participant were further tested for HCV viraemia by RT-PCR, HCV genotyping by RFLP and HIV load by NASBA. Testing results were compared between coinfection group and HIV monoinfection group and among different HCV genotype groups. Result Effect on HCV diagnosis： 8 of the 41 HCV antibody negative patients were HCV RNA positive , and false negative rate is 19.5% . Statistical analysis shows that HCV RNA positive, lb ＋ 2a genotype and genotype 1 b were independently associated with higher A and S/CO value of HCV EIA testing. Effect on HIV diagnosis ： HIV ELISA A value 〈 3 of coinfection group and HIV monoinfected group were 4/ 265 and 5/41 respectively （P 〈0. 01 ） ; Adjusting for CD4 and comparing the 77 HIV WB band result, the coinfected patients has statistically more P55 band presence （P 〈 0. 01 ） ,while the difference on other band was not found. Conclusion The false HCV Ab negative result due to the immune dysfunction by HIV was comparably very high in our studied HIV infected population. HCV RNA quabtive testing was highly recommended for this population. HIV/HCV coinfection may impact the humoral immune response and increase the HIV antibody titer, which lead to the higher A value of HIV ELISA and more P55 band presence. HCV RNA positive, lb ＋ 2a genotype and genotype lb are independent determinant for S/CO value of HCV EIA testing.
出处
《中华检验医学杂志》
CAS
CSCD
北大核心
2005年第7期691-693,共3页
Chinese Journal of Laboratory Medicine
基金
国家"十五"医学科技攻关课题(2001BA705B01)
