Establishment Of The Detection Method For HIV-1Antibody In Needle Residual Blood And Its Application Among Intravenous Drug Users

Objectives:To establish the Micro Liquid-Particle Agglutinate (ML-PA) test method for detecting HIV-1antibody in needle residual blood by detecting HIV-1antibody in needle residual blood among intravenous drug users with this method, and to apply it to study the infection rate and current infection status of HIV among intravenous drug users.Methods:At the establishment stage:Test1was carried out to explore the feasibility of the ML-PA test method for detecting HIV-1antibody in needle residual blood. In June2010, we collected5hemospastic needles of the known positive HIV infectious, and detected HIV-1antibody in their needle residual blood with the ML-PA test method. Test2was carried out to learn about whether this method could still detect HIV-1antibody when needle residual blood was stored for a different time at normal temperature. In June2010, we chose10intravenous drug users, among whom8users were the known positive HIV infectious and2were the known HIV negative infectious, and10healthy persons identified by physical examinations. We made10residual blood needles with every blood sample. The specific approach was as below:Firstly, extract2ml of blood with a clean needle and put blood into a clean tube. Secondly, extract some blood on average with10clean needles from the tube. Thirdly, empty all blood in10needles back to the original tube. Finally, repeating the above steps for10times. All needle residual blood was numbered and stored at normal temperature and then sent for the detecting of HIV-1antibody at7days,1month,2months,6months, and a year, respectively,2needles each time and5times in total. All results were ollected. Test3was carried out to further test whether this method could detect HIV-1antibody in needle residual blood, through a small field experiment. In October2010, we detected HIV-1antibody in both serum and needle residual blood of126fresh intravenous drug users at a rehab located in Yingjiang county, Dehong state, and analyzed the consistency of comparison of the two results. At the application stage:In April2012, combined with the investigation work by the disease prevention and control center of Yuxi state, Yunnan province about the current infection status of HIV among intravenous drug users,3ml-5ml of venous blood per one among536intravenous drug users in the third compulsory detoxification of Yunnan province was collected for the detection of HIV-1antibody in serum with the ELISA method, and meanwhile536needle residual blood was collected for the detection of HIV-1antibody. Positive serum results were confirmed by the WB method. All detection results were collected. In addition, a unified epidemiological questionnaire named "A Health Survey Questionnaire for Drug Addicts" developed by the disease prevention and control center of Yunnan province was applied on all536people for a behavioral survey. Contents of the questionnaire include basic demographic characteristics such as age, ethnic, cultural degree, et al.; high-risk intravenous behaviors, high-risk sex behaviors, acceptance of HIV related services; awareness of AIDS related knowledge:There were8basic AIDS related subjects in total,1score for a right answer,0for a wrong or unknown answer, and full marks were8scores. Awareness of AIDS related knowledge referred to scores of8core questions about AIDS related knowledges6, according to the National AIDS prevention, control, supervision and assessment scheme. Statistical method:Epidata3.1software library was used to input data, and statistical analyses were performed on data using SPSS19.0statistical software. According to the property of data, a corresponding statistical method for processing was selected. Count data was processed by χ2inspection percentage bar chart,column diagram; Related risk factors were analyzed by Logistic regression analysis. P<0.05indicated the difference was statistically significant.Results:At the establishment stage:3preliminary tests were all successful. The sensitivity and specificity of the ML-PA test method for detecting HIV-1antibody in needle residual blood among intravenous drug users were both100%.At the application stage:At the third compulsory detoxification of Yunnan province, detection results of HIV-1antibody in needle residual blood by the ML-PA test method were the same as those in the serum by the ELISA method, and the sensitivity and specificity of the ML-PAtest were both100%.66people were positive,470people were negative, and the positive rate was12.31%. Among66positive people,65were males (98.5%),1was a female (1.5%),59had injected drugs (90.8%);49(74.2%) were between the age of31-40years. By χ2test, there was a statistical difference (P<0.05) of age among intravenous drug users;13(14.4%); Infection or noninfection of HIV was associated with whether sharing needles with others or not, whether injecting drugs or not, age, frequency of injecting drugs, types of drugs, whether accepting condoms propaganda and dispensing/AIDS counseling and testing services or not (P<0.05). As for influence factors of HIV infection among intravenous drug users, it showed (OR=5.408,95%CI:1.262～23.177) for the average daily times of injections; and (OR=0.291,95%CI:0.098～0.862) for drug therapy and clean needle offers/exchanges in the community. Awareness rate of AIDS related knowledge for not less than6right answers was95.6%.Conclusions:(1) This study successfully established the ML-PA test method for detecting HIV-1antibody in needle residual blood.(2) This method can be applied to research into the infection rate and current infection status of HIV.