摘要目的 评价集合核酸检测方法在低档场所女性性工作者(FSWs)HIV急性感染诊断中的应用价值.方法 对广西壮族自治区2011年低档场所FSWs进行调查,并采集血液,采用胶体硒法对HIV抗体初筛检测；对初筛阴性者采用集合核酸检测方法检测HIVRNA,若为阳性,3个月内随访并采集血液进行确证；应用估算公式计算HIV年发病率.结果 共收集6 469例FSWs的血液样本,HIV抗体初筛阳性139例,阳性率为2.15％.刘6 330例初筛阴性者进行集合核酸检测,7例为HIVRNA阳性.3个月内随访检测,6例出现HIV-1抗体阳转,诊断为HIV急性感染者. 2011年广西低档场所FSWs的HIV年发病率为1.45 (95％CI:1.17 ～ 1.76)/100人年.结论 集合核酸检测用于HIV传播的高危人群检测可以发现急性感染者.

abstractsObjective To examine the feasibility of RNA pooling technique in the diagnosis on acute HIV infection among female sex workers (FSWs) working at the low-grade venues.Methods Plasma samples from the low-grade-venue FSWs in Guangxi,in 2011 were tested for HIV antibody using the rapid testing method.All samples which were HIV antibody negative in the rapid testing were tested for HIV RNA with RNA pooling technique.FSWs who showed HIV RNA positive were tested for HIV antibody by Western blot method in 3 months.The HIV incidence in the low-grade venue FSWs was counted under the estimation formula.Results There were 6 469 cases of FSWs who were recruited in this study.Through rapid testing,results showed that HIV antibody was positive in 139 cases,with the positive rate as 2.15％.6 330 FSWs with HIV antibody negative were tested by HIV RNA pooling method,with 7 of them showing HIV RNA positive,in which 6 cases showed HIV-1 antibody seroconversion,thus were diagnosed as acute HIV infection.HIV incidence in low-grade FSWs appeared to be 1.45 per 100 person years (95％CI:1.17-1.76 per 100 person years) in Guangxi.Conclusion Other than regular routine HIV antibody testing,it seemed necessary to adopt the HIV RNA pooling strategy in high-risk groups such as FSWs,so as to early detect the HIV infection and to timely perform the intervention or treatment programs to prevent sexual transmission of HIV.