Zacharias Nikolaos M, Athanassaki Ioanna D, Sangi-Haghpeykar Haleh, Gardner Michael O
Obstetrics and Gynecology Department, Baylor College of Medicine, Houston, TX, USA.
J Perinatol. 2004 Dec;24(12):743-7. doi: 10.1038/sj.jp.7211184.
To identify the characteristics of the gravidas delivering at our birthing center that place them at risk for false-positive human immunodeficiency virus (HIV) enzyme-linked immunosorbent assay (ELISA).
The medical records of all rapid HIV-ELISA-positive gravidas that delivered at our hospital between January 2000 and October 2001 were retrieved, and information was gathered regarding maternal demographics. The results of the Western blot tests were also retrieved and correlated to the ELISA results, across varying maternal characteristics. chi(2), Student's t-test and multivariate analysis were performed, as appropriate, using the SAS software; statistical significance was denoted by p<0.05.
A total of 69 patients had a positive rapid HIV-ELISA out of 9,781 deliveries. Of those, 26 were confirmed as HIV infected by Western blot (overall HIV prevalence: 0.27%, ELISA-positive predictive value: 37.7%). The subgroup prevalence of HIV and positive predictive value of ELISA were 1.53 and 75% among Caucasians; 2.43 and 82.6% among African-Americans; and 0.05 and 9.8% among Hispanics, respectively (p<0.05 for the comparisons between Hispanics and non-Hispanics only). A history of multiple (> or =5 lifetime) sexual partners was elicited in the majority of HIV-infected patients.
The positive predictive value of rapid HIV-ELISA during pregnancy varies widely, depending on maternal race/ethnicity and sexual behavior. The routine disclosure of rapid intrapartum HIV serum screening results prior to Western blot confirmation should be avoided in very low-risk populations.
确定在我们分娩中心分娩的孕妇中，使其有人类免疫缺陷病毒（HIV）酶联免疫吸附测定（ELISA）假阳性风险的特征。
检索了2000年1月至2001年10月在我院分娩的所有HIV快速ELISA阳性孕妇的病历，并收集了产妇人口统计学信息。还检索了免疫印迹试验结果，并将其与ELISA结果进行关联，分析不同产妇特征的情况。酌情使用SAS软件进行卡方检验、学生t检验和多变量分析；统计学显著性以p<0.05表示。
在9781例分娩中，共有69例患者HIV快速ELISA检测呈阳性。其中，26例经免疫印迹确认为HIV感染（总体HIV患病率：0.27%，ELISA阳性预测值：37.7%）。白种人中HIV亚组患病率和ELISA阳性预测值分别为1.53和75%；非裔美国人中为2.43和82.6%；西班牙裔中为0.05和9.8%（仅西班牙裔与非西班牙裔之间的比较p<0.05）。大多数HIV感染患者有多个（≥5个终身）性伴侣史。
孕期HIV快速ELISA的阳性预测值差异很大，取决于产妇的种族/民族和性行为。在极低风险人群中，应避免在免疫印迹确认之前常规公布分娩时HIV血清快速筛查结果。
