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[接受慢性血液透析患者的HIV病毒检测假阳性结果]

[False positive results of HIV virus tests in patients undergoing chronic hemodialysis].

作者信息

Ujhelyi E, Gál G, Makó J, Füst G, Büki B, Nagy K, Ferenc D T, Dietrich M P, Hengster P, Mayer V

出版信息

Orv Hetil. 1989 Jan 8;130(2):67-70.

PMID:2643779
Abstract

The sera of 173 haemodialysis patients treated in two dialysis centers in Hungary were tested for the presence of HIV (HTLV III/LAV) antibodies. Four different commercial enzyme immunoassay (EIA) kits and two types (CEM/LAV, and H9/HTLV III) of indirect immunofluorescence assay (IFA) were used. The Western blot technique was applied as confirmatory test in the study. No confirmed positive results were found in any of the cases. However, in 15 patients (8.7%) false positive (not confirmable by the Western blot assay) results were obtained in at least one but mostly in all of the three type 1 EIA kits (ORGANON, ELECTRONUCLEONICS, SORIN) applied. In 4 patients, the IFA assay also gave false positive results which could be repeated in sequential samples taken from the same patients. Increased reactivity in the control plate (coated with a concentrate of cellular material shed by uninfected H9 cell line) of the SORIN kit was found only in a few false positive samples and no fluorescence with the uninfected H9 or CEM cells was observed in any of the sera showing a false positive IFA. These results indicate that the false positive anti-HIV results frequently observable in haemodialysis patients are not simply the consequence of the presence of antibodies reacting with the uninfected H9 and/or CEM cells but they are most probably due to antibodies against antigens expressed on these cells only after infection with the human immunodeficiency virus.

摘要

对在匈牙利两个透析中心接受治疗的173名血液透析患者的血清进行了HIV(HTLV III/LAV)抗体检测。使用了四种不同的商业酶免疫测定(EIA)试剂盒以及两种类型(CEM/LAV和H9/HTLV III)的间接免疫荧光测定(IFA)。研究中采用蛋白质印迹技术作为确证试验。所有病例均未发现确诊的阳性结果。然而,在15名患者(8.7%)中,至少在应用的三种1型EIA试剂盒(欧加农、电子核子学、索林)中的一种,多数情况下是在所有试剂盒中,获得了假阳性(蛋白质印迹试验无法确证)结果。在4名患者中,IFA检测也给出了假阳性结果,这些结果在从同一患者采集的连续样本中可以重复出现。仅在少数假阳性样本中发现索林试剂盒的对照板(包被有未感染的H9细胞系脱落的细胞物质浓缩物)反应性增加,并且在任何显示IFA假阳性的血清中,均未观察到与未感染的H9或CEM细胞产生荧光。这些结果表明,血液透析患者中经常观察到的抗HIV假阳性结果并非仅仅是与未感染的H9和/或CEM细胞发生反应的抗体存在的结果,而很可能是由于仅在感染人类免疫缺陷病毒后针对这些细胞上表达的抗原产生的抗体所致。

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