如何识别艾滋病晚期的抗体诊断盲区?

How to address antibody diagnosis blind spot for late AIDS

  • 摘要: 艾滋病晚期患者因为免疫系统崩溃,导致抗体产生不足甚至缺失(血清学阴性艾滋病),从而使依赖抗体检测的常规诊断方法失效,造成漏诊或延误诊断,这是临床诊断的一个盲区。对于抗体筛查阳性、确证检测结果不确定、具备艾滋病晚期机会性感染或并发症的病例,结合流行病学史、临床症状和CD4+ T淋巴细胞计数,及时进行核酸检测是避免漏诊、误诊的关键,从而跳出艾滋病晚期抗体严重丢失的诊断盲区。目前,《全国艾滋病检测技术规范(2025年修订版)》已将核酸检测推荐为首选诊断技术和方法,有助于发现和诊断艾滋病晚期患者。

     

    Abstract: Because of immune system collapse, AIDS patients in late stage usually have insufficient or no antibody production (serological negative AIDS), resulting in failure of conventional diagnosis based on antibody detection and missed diagnosis or delayed diagnosis. This is called the the blind spot in clinical AIDS diagnosis. For the antibody screening positive cases, the cases with uncertain confirmation test results and the cases with late opportunistic infections or complications, it is essential to conduct timely nucleic acid detection based on epidemiological history, clinical symptoms and CD4+T lymphocyte count to avoid missed diagnosis and misdiagnosis in AIDS diagnosis in late stage. Nucleic acid detection is recommended as the preferred diagnostic technique and method in National Technical Specifications for HIV/AIDS Testing (Revised Edition 2025) to facilitate the detection and diagnosis of AIDS in late stage.

     

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