HIV阳性患者梅毒合并感染情况及Architect梅毒螺旋体ELISA筛查试验性能的调查。

Investigation of syphilis coinfection and performance of the Architect Syphilis Tp ELISA screening test in HIV positive patients.

作者信息

Sönmez Cemile, Demir Tülin, Sezen Figen, Kılıç Selçuk

机构信息

Public Health General Directorate, Ministry of Health, Ankara, Turkey

Department of Medical Microbiology, İstanbul Medical Faculty, University of Health Sciences, İstanbul, Turkey

出版信息

Turk J Med Sci. 2018 Dec 12;48(6):1129-1134. doi: 10.3906/sag-1802-16.

DOI:10.3906/sag-1802-16

PMID:30541237

Abstract

BACKGROUND/AIM: Limited data on syphilis coinfection in human immunodeficiency virus (HIV) positive cases exist in Turkey. Our aim is to investigate syphilis coinfection and to evaluate the compatibility of the screening Architect Syphilis Tp ELISA with the fluorescent treponemal antibody absorption (FTA-abs) confirmation test in HIV positive cases.

MATERIALS AND METHODS

Totally 519 HIV positive patients were included in the study. Enzyme linked fluorescent assay (ELFA) was used as a screening test and positive samples were confirmed by line immunassay (LIA). In order to discriminate acute HIV infection and false ELISA positivity, HIV-1 RNA PCR was performed in ELFA positive and LIA negative samples. Architect Syphilis TP ELISA was used for the detection of total antibodies against Treponema pallidum in HIV positive patients. Positive results were confirmed by the FTA-abs test.

RESULTS

Out of 519 HIV-1 positive patients, IgG and IgM positivity, and only IgG positivity was detected as 1.9% and 11.4% in all the samples, respectively. A total of 79 (15.2%) sera were positive with Architect Syphilis Tp ELISA test and 69 (13.3%) were positive with FTA-abs test. Statistically significant, almost perfect agreement was found between Architect Syphilis Tp ELISA and FTA-abs tests (kappa = 0.921 and P < 0.001).

CONCLUSION

Implementation of syphilis and HIV screening tests together among risk groups is considered to be appropriate.

摘要

背景/目的：土耳其关于人类免疫缺陷病毒（HIV）阳性病例中梅毒合并感染的数据有限。我们的目的是调查梅毒合并感染情况，并评估HIV阳性病例中梅毒螺旋体酶联免疫吸附测定（Architect Syphilis Tp ELISA）筛查与荧光密螺旋体抗体吸收（FTA-abs）确证试验的一致性。

材料与方法

本研究共纳入519例HIV阳性患者。采用酶联荧光分析法（ELFA）进行筛查，阳性样本通过线性免疫测定（LIA）确证。为鉴别急性HIV感染和ELISA假阳性，对ELFA阳性而LIA阴性的样本进行HIV-1 RNA聚合酶链反应（PCR）检测。采用梅毒螺旋体酶联免疫吸附测定（Architect Syphilis TP ELISA）检测HIV阳性患者血清中抗梅毒螺旋体总抗体。阳性结果通过FTA-abs试验确证。

结果

在519例HIV-1阳性患者中，所有样本的IgG和IgM阳性率以及仅IgG阳性率分别为1.9%和11.4%。梅毒螺旋体酶联免疫吸附测定（Architect Syphilis Tp ELISA）检测共有79份（15.2%）血清呈阳性，FTA-abs试验检测共有69份（13.3%）血清呈阳性。梅毒螺旋体酶联免疫吸附测定（Architect Syphilis Tp ELISA）与FTA-abs试验之间存在统计学显著的、几乎完全一致的结果（kappa = 0.921，P < 0.001）。