Yerly S, Simon F, Perrin L
Laboratoire de Virologie, Hôptal Universitaire de Genève.
Schweiz Med Wochenschr. 1999 Feb 27;129(8):319-22.
Laboratory diagnosis of HIV infection is based on the detection of HIV antibodies. There is a delay between infection and seroconversion (i.e. the appearance of specific HIV antibodies) corresponding to a window period which may last several weeks. Reduction of the length of the window period might be achieved by using p24 antigen and/or viral nucleic acid detection assays. We have evaluated a new screening assay (VIDAS HIV DUO) designed for the concurrent detection of HIV antibodies and p24 antigen, using sequential samples of 34 HIV-1 seroconverting patients and 236 HIV-positive samples confirmed by Western blot. Results were compared with those obtained with two third-generation anti-HIV antibody screening assays. The 236 confirmed HIV-positive samples including 3 HIV-1 subtype O and 2 HIV-2 samples were found to be positive by the 3 assays. All 128 sequential samples from 34 seroconverting patients were found to be positive using the DUO assay, including 20/20 pre-seroconversion samples (p24 antigen-positive and anti-HIV negative). The new screening assay was positive before a third-generation anti-HIV screening assay gave positive results in 14/34 patients (41%). Using the DUO assay, the mean reduction of the window period was 4 days.
HIV感染的实验室诊断基于HIV抗体的检测。从感染到血清转化（即出现特异性HIV抗体）之间存在延迟，这对应着一个可能持续数周的窗口期。使用p24抗原和/或病毒核酸检测方法可能会缩短窗口期。我们评估了一种新的筛查检测方法（VIDAS HIV DUO），该方法旨在同时检测HIV抗体和p24抗原，使用了34例HIV-1血清转化患者的连续样本以及236例经免疫印迹法确认的HIV阳性样本。将结果与两种第三代抗HIV抗体筛查检测方法的结果进行了比较。236例经确认的HIV阳性样本（包括3例HIV-1 O亚型和2例HIV-2样本）在这三种检测方法中均呈阳性。使用DUO检测方法，发现34例血清转化患者的所有128份连续样本均呈阳性，包括20/20份血清转化前样本（p24抗原阳性且抗HIV阴性）。在第三代抗HIV筛查检测方法得出阳性结果之前，新的筛查检测方法在14/34例患者（41%）中呈阳性。使用DUO检测方法，窗口期平均缩短了4天。
