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[血库中的HIV筛查。第四代检测试剂盒的评估]

[Screening of HIV in blood banks. Evaluation of fourth generation kits].

作者信息

Canna Fernando, Treviño Elena, Domínguez Claudia, Gastaldello Rene, Barbas Gabriela, Cudola Analia, Irizar Marta, Bepre Hector, Gallego Sandra

机构信息

Laboratorio de Virus Linfotrópicos Humanos, Instituto de Virología Dr. José María Vanella, Facultad de Ciencias Médicas, Universidad Nacional de Córdoba, Argentina.

出版信息

Medicina (B Aires). 2003;63(6):685-91.

Abstract

Use of detection tests for p24 HIV antigen (p24Ag) in blood banks in Argentina is recommended by the Argentinean Society of Hemotherapy and Immunohematology. In the blood bank of the National University of Cordoba (Argentina), the recent implementation of the p24Ag screening test has considerably increased the cost of the battery of screening tests and its use in all blood donations has not produced the benefits expected. A 4th generation EIA was evaluated for the screening of HIV in comparison with the currently used assays in the blood bank of National University of Cordoba (3rd generation EIA + p24Ag assay). For this comparison, 11 serum samples from subjects with early HIV infection (early seroconversion period) were tested, as well as 27 serum samples from asymptomatic HIV-infected subjects and other 39 from non-HIV infected subjects. The 3rd generation EIA and the 4th generation EIA showed the same sensitivity value (100%) but the specificity of the 3rd generation EIA was higher (97.5%) comparing with 4th generation (95.1%). Besides, the p24Ag test failed to detect 2 samples from subjects with early HIV infection. These results indicate a good performance of both 3rd and 4th generation assays for screening of HIV. However, due to the lowest cost of 4th generation EIA kit, it could replace the currently used assays for HIV screening in regional blood banks. This screening assay will lead to gain in effectiveness and reduced costs until the detection of HIV RNA can be implemented in blood banks.

摘要

阿根廷血液疗法和免疫血液学协会建议在阿根廷的血库中使用p24 HIV抗原(p24Ag)检测试验。在科尔多瓦国立大学(阿根廷)的血库中,最近实施的p24Ag筛查试验大幅增加了筛查试验组合的成本,并且在所有献血中使用该试验并未产生预期的益处。对一种第四代酶免疫分析(EIA)进行了评估,用于在科尔多瓦国立大学血库中与当前使用的检测方法(第三代EIA + p24Ag检测)进行HIV筛查比较。为了进行这种比较,检测了11份来自早期HIV感染(早期血清转换期)受试者的血清样本,以及27份来自无症状HIV感染受试者的血清样本和其他39份来自非HIV感染受试者的血清样本。第三代EIA和第四代EIA显示出相同的灵敏度值(100%),但与第四代(95.1%)相比,第三代EIA的特异性更高(97.5%)。此外,p24Ag检测未能检测出2份来自早期HIV感染受试者的样本。这些结果表明第三代和第四代检测方法在HIV筛查方面都有良好的表现。然而,由于第四代EIA试剂盒成本最低,它可以替代地区血库中目前使用的HIV筛查检测方法。在血库能够实施HIV RNA检测之前,这种筛查检测方法将提高有效性并降低成本。

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