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Báo cáo y học: "Current antibody-based immunoassay algorithm failed to confirm three late-stage AIDS cases in China: case report"

Tuyển tập báo cáo các nghiên cứu khoa học quốc tế ngành y học dành cho các bạn tham khảo đề tài: Current antibody-based immunoassay algorithm failed to confirm three late-stage AIDS cases in China: case report | Li et al. Virology Journal 2010 7 58 http www.virologyj.eom content 7 1 58 VIROLOGY JOURNAL CASE REPORT Open Access Current antibody-based immunoassay algorithm failed to confirm three late-stage AIDS cases in China case report Yan Li1 2 Jin-Kou Zhao3 Ming Wang 1 Zhi-Gang Han1 Wei-Ping Cai4 Bo-Jian Zheng5 Hui-Fang Xu1 Abstract Background Immunoassays composed of screening and confirmation are the established algorithm to confirm HIV infection in China with a Western blot result as the final diagnosis. Case presentation In this report three late-stage AIDS patients were initially tested HIV antibody positive using multiple screening kits but tested indeterminate using Western blot. HIV infection diagnosis was confirmed based on nucleic acid assays clinic manifestations and epidemiological history. Case A was identified positive at 30 months using Western blot Case B at 8 months and case C remained indeterminate until he died of Kaposi s sarcoma 4 months after HAART. Conclusion The report indicates that current antibody-based testing algorithms may miss late-stage AIDS patients and therefore miss the opportunity for preventing these cases from further transmission. The report also implies that viral load assays is not easy to be universely applicated in developing country like China although it is helpful in diagnosing complicated cases of HIV infection so the counselling before and after testing is imperative to the diagnosis of HIV infection and risk behavior survey on the examinee should be as detailed as possible. Background For the diagnosis of HIV infection in China most diagnostic laboratories use enzyme-linked immunosorbent assay ELISA tests for HIV antibody screening further detection of a positive screened sample is usually carried out by using Western blot which confirms the presence of anti-HIV antibodies 1 . Usually the high sensitivity and specificity of currently used licensed screening and confirmation reagents can ensure satisfactory results .