Neifer S, Molz B
Institut für Mikrobiologie und Hygiene im Berliner Betrieb für Zentrale Gesundheitliche Aufgaben.
Gesundheitswesen. 1995 Aug-Sep;57(8-9):489-93.
The purpose of HIV diagnosis is to establish safely whether there is an infection or not. The enzyme-linked immunosorbent assay (ELISA) as screening test, and the western blot assay for confirmation is the most widely used serologic test system to get this information. Diagnostic problems occur if the two tests yield different results. In our 1993 study 491 (4.4%) of 11,127 tested sera were reactive by ELISA. 39 (7.9%) of these samples could not be confirmed by western blot, giving negative or indeterminate results. In addition, 370 ELISA-negative samples were tested by HIV-1 western blot to detect the infection in the early stage. 115 (31%) of these sera showed indeterminate western blot patterns, the other samples were negative. Results of follow-up investigations of 26 (Table 1) or 11 (Table 2) persons with indefinite serodiagnosis were analysed. HIV infection was not detected in any of these cases. In the literature, persons whose sera were reactive according to ELISA and were indeterminate in western blot, had a 3-5% probability of an aisting HIV infection. In contrast, indeterminate western blot patterns in ELISA-negative sere were without significance for the prognosis as to whether a person was or was not HIV-infected.
HIV诊断的目的是安全地确定是否存在感染。酶联免疫吸附测定（ELISA）作为筛查试验，以及用于确认的蛋白质印迹法是获取此信息最广泛使用的血清学检测系统。如果这两种检测产生不同的结果，就会出现诊断问题。在我们1993年的研究中，11127份检测血清中有491份（4.4%）通过ELISA呈反应性。其中39份（7.9%）样本无法通过蛋白质印迹法确认，结果为阴性或不确定。此外，对370份ELISA阴性样本进行了HIV-1蛋白质印迹法检测，以在早期阶段检测感染情况。其中115份（31%）血清显示蛋白质印迹法结果不确定，其他样本为阴性。对26例（表1）或11例（表2）血清学诊断不确定的患者进行了随访调查分析。在这些病例中均未检测到HIV感染。在文献中，根据ELISA呈反应性且蛋白质印迹法结果不确定的患者，存在现存HIV感染的概率为3%-5%。相比之下，ELISA阴性血清中蛋白质印迹法结果不确定对于一个人是否感染HIV的预后并无意义。
