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一名确诊未感染艾滋病毒的肾癌患者的艾滋病毒筛查试验反应:病例报告

Reaction of HIV screening test for a renal cancer patient confirmed to be uninfected with HIV virus: a case report.

作者信息

Tian Ye, Wu Jiajin, Yang Jie, Xue Jianxin, Peerbocus Muaz, Xie Erfu, Wang Zengjun

机构信息

Department of Urology, The First Affiliated Hospital of Nanjing Medical University, Nanjing, China.

Department of Laboratory Medicine, The First Affiliated Hospital of Nanjing Medical University, Nanjing, China.

出版信息

Transl Androl Urol. 2020 Oct;9(5):2281-2285. doi: 10.21037/tau-20-905.

Abstract

Diagnosis of HIV infection and AIDS need to rely on HIV antibody or HIV antigen test internationally, and the test process is divided into preliminary screening test and confirmatory test. The HIV/AIDS screening laboratory of the First Affiliated Hospital of Nanjing Medical University has been using electrochemiluminescence (ECL) to screen the patients. A 50-year-old man with his enhanced computed tomography (CT) scan revealing two soft tissue density images were seen in the left kidney came to the hospital for medical treatment. The patient's postoperative pathological examination revealed (left kidney) renal clear cell carcinoma. The HIV screening tests of the patient several times in perioperative period showed reactivity, but the result of the confirmatory tests of Nanjing Municipal Center for Disease Control and Prevention were negative all the time. False positive HIV results are quite rare in the setting of renal clear cell carcinoma. There must be some substances that can react with the HIV Combi PT designed to detect anti-HIV antibodies of the IgG- and IgM-class as well as HIV p24 antigen in this patient. In conclusion, false positive results of HIV screening test may occur in serum of patients with renal cell carcinoma, and necessary confirmatory tests are needed. When clinicians encounter such problems, confirmatory tests should be conducted according to the guidelines to avoid misdiagnosis.

摘要

国际上对HIV感染和艾滋病的诊断需依靠HIV抗体或HIV抗原检测,检测过程分为初筛检测和确证检测。南京医科大学第一附属医院的HIV/AIDS筛查实验室一直采用电化学发光法(ECL)对患者进行筛查。一名50岁男性因增强计算机断层扫描(CT)显示左肾有两个软组织密度影而来院就诊。患者术后病理检查显示(左肾)肾透明细胞癌。该患者围手术期多次HIV筛查检测呈反应性,但南京市疾病预防控制中心的确证检测结果一直为阴性。在肾透明细胞癌病例中,HIV检测结果出现假阳性相当罕见。该患者血清中必定存在某些能与用于检测IgG和IgM类抗HIV抗体以及HIV p24抗原的HIV Combi PT发生反应的物质。总之,肾细胞癌患者血清中可能出现HIV筛查检测假阳性结果,需要进行必要的确证检测。临床医生遇到此类问题时,应按指南进行确证检测以避免误诊。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/883e/7658161/a621ac0d00ae/tau-09-05-2281-f1.jpg

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