| Objective Collecting the HIV antibody screening and confirmatory test reports of suspected HIV infection cases from 2016 to 2018 in Lu'an city,to analyze the source of positive samples,the positive coincidence rate of preliminary screening and confirmatory experiments,the characteristics of positive or uncertain samples confirmation bands and gene distribution.Then further exploring the HIV infection situation in Lu'an city in the past three years and the detection ability of each preliminary screening laboratory.In order to improve the accuracy of HIV screening test results,we select two most widely used HIV screening reagents for quality evaluation,to verify its clinical value and discuss the strategy of reagent selection.Analyzing the prevalence and influencing factors of AIDS epidemic in different years and populations in Lu'an city systematically,by investigating the network report data of HIV confirmed cases from 2016 to 2018 in Lu'an city,combined with their social demographic characteristics and behavioral characteristics,so as to clarify the main links of transmission routes and key populations,finding effective prevention and control models,providing a basis for formulating scientific control strategies and measures.Methods Collecting the suspected HIV infected serum samples after primary screening test from 2016-2018 in Lu'an city,and carrying out the confirmation test one by one.We selected a serum disk composed of 70 HIV-Ab positive specimens and122 HIV-Ab negative specimens.The results of HIV confirmatory test were used as the gold standard to judge the true positive and true negative.Two of the most widely used HIV screening reagents in Lu'an city were used for parallel determination of serum disk.The sensitivity,specificity,efficacy rate,Jordan index,positive predictive value and negative predictive value of the two reagents were compared and analyzed.Investigating the report cards,attachment cards and cases follow-up table of confirmed HIV infected cases in Lu'an city from 2016 to 2018 from the network of the integrated AIDS prevention and control information system of the Chinese disease control and prevention system,The software Excel 2007 was used to double-input data such as time of case report,reporting area,case household register,general demographic characteristics(gender,age,nationality,marital status,education level,occupation),route of infection,etc.,and SPSS 16.0 was used for statistical processing of the data.The difference was statistically significant(P<0.05).Descriptive epidemiological methods were used to describe the time distribution,regional distribution,population distribution and infection route characteristics of HIV cases reported from 2016 to 2018 in Lu'an city.Results From 2016 to 2018,a total of 739 blood samples of suspected HIV infections were tested in the confirmation laboratory of Lu 'an city,of which a total of477 were HIV-1 positive,97 were uncertain,and 165 were negative.HIV-2 were all negative.There 303 delivery institutions of confirmed positive samples were medical institutions,153 were centers for disease control and prevention(CDC).The main examination categories were hospitalization examination(214 cases)and voluntary counseling examination(VCT)(110 cases).The total positive coincidence rate between screening test and confirmatory test in three years was 64.55%(477 / 739),which was 63.37%,66.29% and 63.97% respectively.The highest positive coincidence rates found in the delivery institution were CDC(89.47%)and VCT(92.44%).There were 33 types of positive results,the top three were gp160gp120gp41p66p51p31p24p17(44.44%),gp160gp120gp41p66p51p55p31p24p17(16.14%),gp160gp120gp41p31p24p17(9.64%);397(83.23%)of them appeared in the whole band and sub whole band(? 6 bands);p24 appeared in the highest frequency(99.37%)and p55 in the lowest frequency(16.35%).Among the 97 uncertain band results,p24 had the highest probability(43.30%),followed by p17(35.05%).The two most widely used HIV screening reagents in Lu'an city were the third generation and the fourth generation of HIV ELISA detection reagents.The sensitivity,specificity,efficacy,jordan index,positive predictive value and negative predictive value of the third generation of reagents were 100.00%,99.18%,99.48%,97.66%,98.59% and 100.00% respectively,while the fourth generation were 100.00%,98.36%,98.96%,96.32%,97.22% and 100.00% respectively.A total of 477 HIV infections were reported in all counties and districts of Lu 'an every year from 2016 to2018.There were 128 cases in 2016,175 in 2017 and 174 in 2018.The top three counties were Jin'an district(212 cases),Yu'an district(106 cases)and Huoqiu county(55 cases).The proportion of cases registered in other areas(59.54%)was higher than that registered in local areas(40.46%).There were more male cases(376 cases)than female cases(101 cases),and the sex ratio was 3.72:1.The cases ranged from 8 to 91 years old,and were mainly concentrated in the age group from 20 to 49 years old(61.64%),followed by the age group over 50 years old(35.01%).450 cases were the Han(94.34%)ethnic group.Marital status were in the majority,accounting for53.25%.The education level were mainly in middle school(24.32%)and primary school(15.51%).The distribution of occupations were mainly farmers(31.66%),homemaking,unemployment(12.55%)and workers(9.85%).85.95% of transmission routes were sexual transmission.Conclusions Hospital and CDC were the main institutions of HIV antibody screening in Lu 'an city from 2016 to 2018.The positive coincidence rate was stable between 60% and 70%,which suggested that the ability of the preliminary screening laboratory need to be improved.There were 33 confirmed band types of HIV infected cases,with high detection rates of p24,gp160 and gp41(both >90%)and low detection rates of p55(<20%),indicating that anti-env gene encoded envelope protein antibody was a necessary condition for the diagnosis of HIV infection.Uncertain results accounted for 13.13% of the samples,which should be re-inspected after 2-4weeks.The evaluation of the two most widely used primary screening agents for HIV in Lu 'an city was ideal.There was no significant difference in effect,meeting the requirements of antibody screening test.It was more worthy of clinical promotion as the fourth generation reagent showed a shorter window period.In the past three years,the confirmed cases of HIV infection had been found in all counties and districts of Lu 'an city,focusing on men,young adults,married,low-educated,migrant workers and floating population.From now on,AIDS prevention and control publicity should strengthen sexual safety education and promote the use of condoms. |
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