Department of Pathology and Laboratory Medicine, University of British Columbia, 2329 West Mall, Vancouver, BC, Canada.
Division of Infection Prevention and Control, Providence Health Care, 1081 Burrard Street, Vancouver, BC, Canada.
Eur J Clin Microbiol Infect Dis. 2018 Aug;37(8):1589-1593. doi: 10.1007/s10096-018-3290-y. Epub 2018 Jun 3.
Early and rapid detection of patients with HIV is a key to preventing further transmission. The purpose of this study was to assess the ability of signal-to-cutoff (S/CO) ratio from initial screening fourth-generation HIV serology to predict subsequent confirmation of HIV. Patients with a first-time positive HIV serology (S/CO ratio ≥ 1) from 2012 to 2016 were included. Ratios were compared to the results of confirmatory testing. Predictive probabilities (PPs) of a positive confirmatory result were calculated based on a logistic regression model. A total of 45,138 HIV serology tests were performed; 250 patients met inclusion criteria, comprising 84 (34%) HIV negative patients, 136 (54%) chronic infections, and 30 (12%) acute infections. The PP of a confirmed positive result increased with higher S/CO ratios, with a PP of 100% for a S/CO of 55 (95% CI 95-100). This study enables a more informed discussion of the probability of HIV infection, based on HIV serology S/CO thresholds, prior to a confirmatory result.
早期和快速检测 HIV 感染者是防止进一步传播的关键。本研究旨在评估初始筛查第四代 HIV 血清学的信号与截止值（S/CO）比值预测随后 HIV 确认的能力。本研究纳入了 2012 年至 2016 年首次 HIV 血清学阳性（S/CO 比值≥1）的患者。比较了比值与确认性检测结果。基于逻辑回归模型计算了阳性确认结果的预测概率（PP）。共进行了 45138 次 HIV 血清学检测；250 名患者符合纳入标准，包括 84 名（34%）HIV 阴性患者、136 名（54%）慢性感染者和 30 名（12%）急性感染者。确认阳性结果的 PP 随着 S/CO 比值的升高而增加，S/CO 为 55 时的 PP 为 100%（95%CI 95-100）。本研究通过 HIV 血清学 S/CO 阈值，在确认结果之前，更能深入讨论 HIV 感染的概率。
