中文摘要：

目的 分析HIV抗体不确定的血清学特征及预示HIV感染的意义,评价3种实验方法鉴别HIV抗体不确定的效果.方法 收集394例HIV抗体不确定标本,分析免疫印迹确认的条带类型.2对97例HIV抗体不确定病例进行随访,观察HIV抗体的发展和变化.3对67例随访病例的首次标本进行病毒载量、条带免疫印迹和HIV-1 p24抗原检测,以随访的结果为金标准,判断3种方法鉴别不确定的效果.结果 394例不确定标本共有38种带型,env类不确定的构成比例是37.54%;pol不确定占4.04%;gag类不确定占的比例最大,为58.37%.97例接受随访的HIV抗体不确定病例中,5例发生HIV抗体阳转,均为env类不确定.阳转病例的HIV抗体发展很快,约2周就可以看出变化.病毒载量检测鉴别HIV抗体不确定的敏感性最好.结论 针对gag蛋白的不确定反应最为常见,但基本上都是非特异反应.env类不确定预示HIV感染的意义较大,特别是gp160p24和gp160.HIV抗体不确定如为早期HIV感染,血清抗体发展的速度很快,大约2周抗体就有发展.病毒载量检测可有效鉴别不确定结果.

英文摘要：

Objective To clarify the serological characteristics and predictive value of HIV antibody indeterminant and to evaluate the efficiency of 3 assays to discriminate HIV antibody indeterminant.Methods Three hundred and ninety-four HIV antibody indeterminant serum samples were collected and the Western blot pattern were analyzed.Ninety-seven HIV antibody indeterminant individuals were followed up,and the development of HIV antibody were observed.The initial serum samples of 67 followed individuals were tested by viral load,line immunoblot assay and ELISA for HIV-1 p24,with the golden standard of follow up,the efficiency of 3 kinds of assay to discriminate HIV antibody indeterminant were evaluated.Results There were 38 patterns among 394 HIV antibody indeterminant,the proportions of env,pol and gag indeterminant were 37.54%,4.04%and 58.37% respectively.Five HIV antibody indeterminant cases were converted to HIV antibody positive among 97 followed individuals,they were all env indeterminant and HIV antibody developed rapidly.HIV viral load was an ideal assay to discriminate HIV antibody indeterminant with best sensitivity.Conclusion The indeterminant of gag were most common,but were unspecific reaction.Env indeterminant were with the greatest predictive value of HIV infection,especially the gp160p24 and gp160.Viral load assay can be applied to discriminate HIV antibody indeterminant.