Arnow P M, Fellner S, Harrington R, Leuther M
Department of Medicine, University of Chicago, IL.
Am J Kidney Dis. 1988 May;11(5):383-6. doi: 10.1016/s0272-6386(88)80050-7.
Eighty-three chronic hemodialysis patients were tested for human immunodeficiency virus (HIV) infection. Testing included screening enzyme immunoassay (EIA) for HIV antibodies, competitive EIA for envelope and core antibodies, EIA for HIV antigen, and lymphocyte culture. Five (6%) of the patients had positive screening EIA at low reactivity. Four of these five had antibodies to H-9 cellular antigens. Comparison of the five seropositive patients to matched controls showed no significant differences in number of lymphocytes or helper/suppressor ratio. Six months later, the five patients had negative screening EIA results using a kit with a manufacturing change approved by the Food and Drug Administration that provided improved specificity. In addition, their Western blot analysis was negative. We conclude that (1) false-positive screening EIA results are more common in chronic hemodialysis patients than other populations; (2) evaluation of chronic hemodialysis patients for HIV infection requires confirmatory tests; and (3) newer EIA screening kits appear to have improved specificity.
对83名慢性血液透析患者进行了人类免疫缺陷病毒（HIV）感染检测。检测包括用于HIV抗体的筛查酶免疫测定（EIA）、用于包膜和核心抗体的竞争性EIA、用于HIV抗原的EIA以及淋巴细胞培养。5名（6%）患者的筛查EIA呈低反应性阳性。这5名患者中有4名具有针对H - 9细胞抗原的抗体。将这5名血清阳性患者与匹配的对照组进行比较，结果显示淋巴细胞数量或辅助/抑制细胞比例无显著差异。6个月后，使用经美国食品药品监督管理局批准、具有更高特异性的生产变更试剂盒，这5名患者的筛查EIA结果为阴性。此外，他们的免疫印迹分析也为阴性。我们得出结论：（1）慢性血液透析患者中EIA筛查结果假阳性比其他人群更常见；（2）对慢性血液透析患者进行HIV感染评估需要进行确证试验；（3）更新的EIA筛查试剂盒似乎具有更高的特异性。
