Screening test results and epidemiological characteristics of people infected with human immunodeficiency virus in the window period confirmed by Western blotting as"negative"
Objective To analyze the screening test results of people infected with human immunodeficiency virus(HIV)in the window period confirmed to be"negative"by Western blotting,with a view to finding a way to identify people infected with HIV during the window period as soon as possible.Methods In the serum(plasma)samples of HIV-positive people screened by the fourth-generation chemiluminescent immunoassay in medical institutions at all levels in Pudong New District,Shanghai from 2014 to 2021,a total of 100 people(200 samples)were confirmed as"negative"and the fourth-generation enzyme-linked immunosorbent assay was screened positive.According to the follow-up results,it was divided into the early infection group(24 cases)and the uninfected group(76 people),and the fourth-generation rapid diagnostic test(RDT)was performed.The compliance rates of positive results of screening and follow-up were compared,and the epidemiological data of early HIV infections were analyzed.The chi-square test was used for statistical analysis.Results Of the 200 samples,48(24.00％)were early infected.A total of 106 samples antigens and(or)antibodies were positive by the fourth-generation RDT screening,and the compliance rate with the follow-up results was 45.28％(48/106),of which those of the fourth-generation RDT screening antigen positive and follow-up results were 100.00％(36/36),which was higher than the antibody positive results(24.68％(19/77)).The difference was statistically significant(x2=57.49,P＜0.001).Of the 24 cases of early HIV infections,19(79.2％)had acute symptoms.Only one out of six people≥50 years old had asked about the partner about his HIV status before engaging high-risk sex,and 13 out of 18 people＜50 years old had asked the partners about their HIV status or to detect HIV before engaging high-risk sex.The difference was statistically significant(x2=5.71,P=0.017).Out of the six people ≥50 years old,only one actively tested HIV,and 12 out of 18 people＜50 years old actively tested HIV,and the difference was statistically significant(x2=4.53,P=0.033).Conclusions The Western blotting confirmed"negative"samples may be false negative.The comprehensive evaluation which combined with the fourth-generation screening test could help to screen out HIV window infection.In addition,the publicity,education and monitoring of high-risk population need to be further strengthened.
Fourth-generation chemiluminescent assayFourth-generation enzyme-linked immunosorbent assayFourth-generation rapid diagnostic test
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