Application and effectiveness of HIV nucleic acid quantitative detection in the one-stop service for AIDS diagnosis and treatment model
Objective The study explores the effectiveness and feasibility of HIV nucleic acid quantitative detection in the one-stop service for AIDS diagnosis and treatment model.The aim is to provide evidence for early diagnosis,early treatment,and improved management of HIV/AIDS patients.Methods The one-stop service for AIDS diagnosis and treatment model was implemented at Puding County People's Hospital.For patients with positive blood initial HIV antibody screening results,nucleic acid quantitative detection was performed in-hospital alongside referral of blood samples to the Guizhou Provincial Center for Disease Control and Prevention for confirmatory antibody assays.In-hospital test results were compared with verification results to assess the feasibility of the on-site testing.Additionally,researchers compared the time intervals between positive initial antibody screening results and receiving antibody confirmatory antibody results or HIV nucleic acid detection results,positive initial antibody screening results and receiving combined antiretroviral therapy(cART)regimens,and the proportion of patients receiving cART regimens within 30 days before and after implementing the one-stop service model.Results Among newly diagnosed patients with positive HIV antibody screening results,in-hospital HIV nucleic acid detection revealed that 94.97％(189/199)of blood samples had viral loads exceeding 5 000 copies/mL.The remaining 4.02％(8/199)of samples with viral loads ≤5 000 copies/mL were later confirmed positive and ultimately became undetectable.Notably,1.01％(2/199)of samples displaced undetectable viral loads.Verification at the Guizhou Provincial Center for Disease Control and Prevention confirmed positive results for 197 patients and negative results for two patients,demonstrating excellent consistency with in-hospital test results(Kappa=1,P＜0.001)and 100.00％(199/199)overall agreement rate.The sensitivity of the in-hospital nucleic acid quantitative test was high(95.94％,189/197),and the specificity was perfect(100.00％,2/2).Following the implementation of the one-stop service model,the median time from positive initial antibody screening results to receiving confirmatory antibody results or nucleic acid quantitative detection results significantly decreased from 8 days to 1 day(P＜0.001).Similarly,the median time to receive cART after a positive initial screening dropped significantly from 16 days to 1 day(P＜0.001).The proportion of newly reported cases receiving cART within 30 days also saw a significant increase(P＜0.001)from 68.00％to 99.49％(196/197)after adopting the one-stop service model.Conclusions This study effectively demonstrates the feasibility of HIV nucleic acid quantitative detection for HIV diagnosis.This approach significantly reduces the time from testing to treatment,allowing HIV/AIDS patients to receive cART therapy promptly.
HIVnucleic acid quantitative detectionone-stop service for AIDS diagnosis and treatmentapplicationeffectiveness
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