Trend of positive screening rate for human immunodeficiency virus and evaluation of screening reagent performance in a grade A tertiary hospital in Shanghai City from 2012 to 2022
Objective To analyze the confirmation rate of human immunodeficiency virus(HIV),the clinical epidemiological characteristics of confirmed HIV-infected individuals,and the performance of HIV screening reagents,so that to provide scientific basis for local development of acquired immunodeficiency syndrome prevention and control measures.Methods Clinical data of HIV infected individuals who were suspected to be positive during the initial screening of HIV in Xinhua Hospital,Shanghai Jiao Tong University School of Medicine and confirmed by the HIV confirmed laboratory of Center for Disease Control and Prevention in Yangpu District Center,Shanghai City from January 2012 to December 2022 were retrospectively analyzed,and the analysis of the clinical epidemiological characteristics of HIV confirmed positive infections was performed.The consistency was analyzed between the screening results and confirmation results of HIV initial screening reagents.Trend chi-square test was used for statistical analysis.Receiver operating characteristic(ROC)curve was used to analyze the diagnostic ability of HIV initial screening chemiluminescence values.Results A total of 702 949 outpatient/inpatient patients and healthy individuals were screened,with 468 suspected positive cases(0.067％)initially screened and 202 confirmed HIV positive cases,with a positive rate of 0.028 7％.The HIV confirmed positive rate showed a downward trend from 2012 to 2022(xtrend=17.28,P＜0.001).Among confirmed HIV positive patients,there were 180 males(89.11％)and 22 females(10.89％).Among the confirmed HIV positive cases,Shanghai City residents accounted for 56.44％(114 cases),while Anhui Province residents accounted for 8.91％(18 cases)and Jiangsu Province residents accounted for 7.92％(16 cases).There were 70 cases(34.65％)of HIV co-infection with Treponema pallidum.The area under the ROC curve of the chemiluminescence value of the HIV initial screening test(chemiluminescence particle immunoassay)was 0.973(95％confidence interval(CI)0.961 to 0.985,P＜0.001).The optimal critical value corresponding to the Youden index was 0.834,and the corresponding chemiluminescence value was 59.48 signal/cut off(S/CO),with the sensitivity of 89.10％and the specificity of 94.30％.The accuracy of HIV antibody colloidal gold method was 85.95％(318/370),with the sensitivity of 98.30％(173/176)and the specificity of 97.32％(145/149).Conclusions The positive rate of HIV testing shows a downward trend.HIV infected people are mainly male,and registered residence is mainly distributed in Shanghai City.The HIV antibody colloidal gold method has high specificity.
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