Orta Mira Nieves, Guna Serrano María del Remedio, Latorre Martínez José-Carlos, Ovies María Rosario, Pérez José L, Gimeno Cardona Concepción
Programa Externo de Control de Calidad SEIMC, España.
Enferm Infecc Microbiol Clin. 2008 Nov;26 Suppl 13:8-13.
Human immunodeficiency virus type 1 (HIV-1) and hepatitis C virus (HCV) viral load determinations are among the most important tasks performed in the molecular microbiology laboratory, due to their importance in patient follow-up. Quality control tools are crucial in these laboratories to ensure the accuracy of the results. This article presents the analysis of the results obtained in 2007 from the SEIMC External Quality Control Program for HIV-1 and HCV viral loads.
In the HIV-1 program, a total of five standards were sent. One standard consisted of seronegative human plasma, while the remaining four contained plasma from three different viremic patients, in a range of 2-5 log(10) copies/mL; to analyze repeatability, two of these standards were identical. The specificity was good for all the methods used by the participants, and only two out of 75 results were considered to be false positive results. A substantial proportion of the laboratories (20% on average) obtained values outside the accepted range (mean +/-0.2 log(10) copies/mL), depending on the standard and on the method used for quantification. A few errors were due to the transcription of the analytical result. Repeatability was also acceptable but approximately 15% of laboratories failed this evaluation. The HCV program consisted of two standards with different viral load contents. Most of the participants (94.6%) obtained results within the accepted range (mean +/-1.96 SD log(10) UI/mL), and interlaboratory variability was <0.5 log units for both standards and all techniques.
Data from this analysis reinforce the utility of proficiency programs to ensure the quality of the results obtained by a particular laboratory, as well as the importance of the post-analytical phase in overall quality. Due to wide interlaboratory variability, the use of the same method and the same laboratory for patient follow-up is advisable.
由于人类免疫缺陷病毒1型(HIV-1)和丙型肝炎病毒(HCV)病毒载量测定对患者随访至关重要,因此是分子微生物学实验室执行的最重要任务之一。质量控制工具对于这些实验室确保结果的准确性至关重要。本文介绍了2007年从西班牙传染病和临床微生物学会(SEIMC)HIV-1和HCV病毒载量外部质量控制计划中获得的结果分析。
在HIV-1计划中,共发送了五个标准品。一个标准品由血清阴性的人血浆组成,其余四个含有来自三名不同病毒血症患者的血浆,范围为2-5 log(10)拷贝/毫升;为分析重复性,其中两个标准品是相同的。参与者使用的所有方法的特异性都很好,75个结果中只有两个被认为是假阳性结果。相当一部分实验室(平均20%)获得的值超出了可接受范围(平均值±0.2 log(10)拷贝/毫升),这取决于标准品和用于定量的方法。一些误差是由于分析结果的转录造成的。重复性也可以接受,但约15%的实验室未通过该评估。HCV计划由两个病毒载量含量不同的标准品组成。大多数参与者(94.6%)获得的结果在可接受范围内(平均值±1.96标准差log(10)国际单位/毫升),并且两个标准品和所有技术的实验室间变异性均<0.5 log单位。
该分析的数据强化了能力验证计划对于确保特定实验室获得的结果质量的效用,以及分析后阶段在整体质量中的重要性。由于实验室间变异性较大,建议在患者随访中使用相同的方法和同一个实验室。