Current HIV-2 Diagnostic Strategy Overestimates HIV-2 Prevalence in China
Current HIV-2 Diagnostic Strategy Overestimates HIV-2 Prevalence in China
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DOI：
10.1002/jmv.21441
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发表时间：
2009-05-01
影响因子：
12.7
通讯作者：
Parekh, Bharat S.
中科院分区：
文献类型：
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作者：
Qiu, Maofeng;Liu, Xin;Parekh, Bharat S.
根据中国现行的HIV-2诊断指南，在中国使用Western blot检测报告了大量HIV-2感染病例。然而，大多数标本在HIV-1 Western blot上也呈阳性，提示交叉反应性和可能的高估。本研究旨在评估中国HIV-2感染的诊断策略。根据中国现行指南，使用Genelabs Western blot （HIV blot 2.2 WB）进行检测时，来自16个省的119份标本可能为HIV-2。进一步的HIV-2 WB检测（Bio-Rad New LAV Blot 11或Genelabs HIV Blot 1.2 WB）显示，119份样本中有56份（47.1%）显示HIV-2感染，63份（52.9%）HIV-2不确定。一种基于多肽的HIV-1和HIV-2酶免疫试验被验证并用于HIV-1和HIV-2感染的鉴别诊断。该内部EIA表明，119个标本中只有1个（0.8%）具有HIV-2特异性抗体，而2个（1.7%）具有双反应性。这些结果与innoi - lia HIV-I/II （Innogenetics，比利时）的结果高度一致（bb0 99%），后者也使用特异性肽进行特异性诊断。我们的数据表明，HIV-2感染在中国是罕见的，HIV-2 Western blot可能高估了HIV-1人群中HIV-2的患病率。中国的HIV-2诊断策略需要修订，以包括更具体的基于肽的免疫测定。中华医学杂志，2009,31(1):790-797。(C) 2009 Wiley-Liss, Inc。
A significant number of HIV-2 infections have been reported in China using Western blot as per current guidelines for HIV-2 diagnosis in China. However, most specimens were also positive on HIV-1 Western blot suggesting cross-reactivity and possible overestimation. We carried out the current study to evaluate a strategy to diagnose the HIV-2 infections in China. A total of 119 specimens received from 16 provinces were likely to be HIV-2 when tested according to current guidelines in China using the Genelabs Western blot (HIV Blot 2.2 WB). Further testing by HIV-2 WB (Bio-Rad New LAV Blot 11 or Genelabs HIV Blot 1.2 WB) scored 56 (47.1%) of 119 samples with banding pattern suggestive of HIV-2 infection, and 63 (52.9%) were HIV-2 indeterminate. A peptide-based HIV-1 and HIV-2 enzyme immuno assay for differential diagnosis of HIV-1 and HIV-2 infections was validated and used. This in-house EIA demonstrated that only 1 (0.8%) of 119 specimens had HIV-2 specific antibodies, while 2 (1.7%) were dually reactive. These results were highly concordant (>99%) with those by Inno-LIA HIV-I/II (Innogenetics, Belgium), which also use specific peptides for type-specific diagnosis. Our data demonstrates that HIV-2 infection is rare in China, and HIV-2 Western blot may overestimate the prevalence of HIV-2 in the population with HIV-1. The HIV-2 diagnostic strategy in China needs to be revised to include more specific peptide-based immunoassays. J. Med. Virol. 81:790-797,2009. (C) 2009 Wiley-Liss, Inc.