| 摘要: |
| ［摘要］ 目的 比较三种新近感染综合判定策略（RITAs）判定四川省某市新报告HIV-1感染者新近感染的效能。方法 收集四川省某市2022—2024年新报告HIV-1感染者资料，基于样本基线不同指标组合分为三种判定策略：未接受抗病毒治疗+限制性抗原亲和力酶联免疫法（LAg-EIA）+CD4+ T淋巴细胞计数为RITA1；未接受抗病毒治疗+LAg-EIA+基线病毒载量为RITA2；未接受抗病毒治疗+LAg-EIA+CD4+ T淋巴细胞计数+基线病毒载量为RITA3。以感染时间判定新近感染的策略为本研究参考策略，分别计算三种RITAs的符合率，利用χ2检验和受试者工作特征（ROC）曲线分析比较不同策略的判定效能。结果 该研究共纳入349例HIV-1感染者，主要以异性性传播（95.13%）、55岁及以上（76.79%）、男性（66.19%）为主，150例（42.98%）首次CD4+ T淋巴细胞计数<200个/μL。RITA1、RITA2和RITA3的符合率分别为71.92%、69.63%、71.92%。综合χ2检验和ROC曲线分析结果，RITA1和RITA2与参考策略对HIV-1新近感染的判定结果无显著差异，有一定应用价值。RITA2的特异度最高，为0.762，ROC曲线下面积为0.600（95%CI：0.525～0.674）。结论 将免疫学和病毒学指标纳入现有HIV-1的RITAs有一定的判定意义，各地应根据本地疫情特点及HIV-1感染者基线检测数据情况，选择合适的判定策略。 |
| 关键词: 人类免疫缺陷病毒-1 新近感染综合判定策略 限制性抗原亲和力酶联免疫检测 基线病毒载量 CD4+ T淋巴细胞计数 艾滋病病毒感染 |
| DOI：10.3969/j.issn.1674-3806.2025.04.05 |
| 分类号:R 512.91 |
| 基金项目:国家自然科学基金委员会专项项目（编号：82341035） |
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| Comparison of predictive efficacy of three recent infection testing algorithms for recent infections in newly reported HIV-1 infected individuals |
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YANG Hong1, ZHANG Ying2, WANG Nan1, WAN Xiaoyu2, XIAO Li2, ZHOU Chang1, LIANG Shu1
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1.Institute for Sexually Transmitted Disease and Acquired Immunodeficiency Syndrome Prevention and Control, Sichuan Center for Disease Control and Prevention, Chengdu 610044, China; 2.Institute for Sexually Transmitted Disease and Acquired Immunodeficiency Syndrome Prevention and Control, Zigong Center for Disease Control and Prevention, Zigong 643000, China
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| Abstract: |
| ［Abstract］ Objective To compare the predictive efficacy of three recent infection testing algorithms(RITAs) for recent infections in newly reported human immunodeficiency virus(HIV)-1 infected individuals in a city of Sichuan Province. Methods The data of newly reported HIV-1 infected individuals in a city of Sichuan Province from 2022 to 2024 were collected. Based on the different baselines of the samples, the combinations of indicators were divided into three RITAs: no antiviral treatment+limiting antigen avidity enzyme immunoassay(LAg-EIA)+CD4+ T-lymphocyte count(RITA1); no antiviral treatment+LAg-EIA+baseline viral load(RITA2); no antiviral treatment+LAg-EIA+CD4+ T-lymphocyte count+baseline viral load(RITA3). Taking the prediction of recent infections by infection time as the reference strategy in this study, the coincidence rates of the three RITAs were calculated respectively. The predictive efficacy of different strategies was compared by using χ2 test and receiver operating characteristic(ROC) curve analysis. Results A total of 349 patients with HIV-1 infection were included in this study. These HIV-1 infection patients were infected mainly through heterosexual sexual transmission(95.13%), aged 55 years and above(76.79%), and male(66.19%). The first CD4+ T-lymphocyte count was less than 200 cells/μL in 150 cases(42.98%). The coincidence rates of RITA1, RITA2 and RITA3 were 71.92%, 69.63% and 71.92%, respectively. Based on the comprehensive results of χ2 test and ROC curve analysis, RITA1 and RITA2 showed no significant difference in the prediction of recent infections of HIV-1 compared with the reference strategy, with certain application value. The specificity of RITA2 was the highest, which was 0.762, and the area under its ROC curve was 0.600(95%CI: 0.525-0.674). Conclusion Incorporating immunological and virological indicators into existing RITAs for HIV-1 has certain predictive significance for recent infections in newly reported HIV-1 infected individuals. Each region should select appropriate predictive strategies based on the local epidemic situation and the baseline test data of the HIV-1 infected individuals. |
| Key words: Human immunodeficiency virus-1(HIV-1) Recent infection testing algorithms(RITAs) Limiting antigen avidity enzyme immunoassay(LAg-EIA) Baseline viral load CD4+ T-lymphocyte count Human immunodeficiency virus infection |
