艾滋病检测窗口期

　　艾滋病检测窗口期

　　近来有许多人来电询问有关艾滋病检测的窗口期问题，而且有许多资料介绍的信息不一致，有的说1个月，有的说3个月，有的说6个月等。许多人2个月、3个月时做HIV抗体检测结果阴性，好容易解除了思想顾虑，忽然看到有资料载或听他人说要等到6个月做检测，心理负担又加重，几乎天天打咨询电话询问，述说如再熬3个月，感到精神压力实在承受不了等。为此，我们特将我国著名艾滋病专家曹韵贞教授在中国生殖健康网上与网民交流中有关艾滋病检测方面的问答摘录如下：

　　    曹韵贞：艾滋病检测窗口期艾滋病病毒（HIV）进入人体后高速度的复制，引起一个所谓的急性的病毒血症。HIV侵犯的是CD4细胞，或者说是淋巴系统，因此会出现一个类似单核细胞增多症的症状，这个症状往往是7～12天，所以艾滋病的急性临床期在2周内。2周内可出现单核细胞增多症的症状，包括喉咙痛，低烧，皮肤有斑，颈部以上淋巴结肿大或有点腰酸背痛等。从病毒接触后就产生细胞免疫和体液免疫，抗体在2～6周后产生，一般人如果真有感染的话，大概一个半月后就有抗体了,它不会延长到3个月、6个月、一年。

　　    曹韵贞：我不知道为什么把这个窗口期的时间改了，这是一个科学的结论，这个4～6周是我们经过长期的很多病例而定的，这是一个科学的结论。另外还有个别的情况，自己说不清楚什么时候感染的，他从感染后到检查不是1周、2周去查的。我们讲的所谓4～6周是结合众多的病例得出来一个科学的结论。

　　    问：为什么许多专家说窗口期要6个月，有的说抗体还没有产生。艾滋病论坛

　　    曹韵贞：艾滋病检测窗口期现在专家太多了，作为一个内科医生，对抗体说3个月、6个月我没意见，不是所有的人都看到过急性的病人，也不是所有的人都对每个急性病人都进行大量的检查。我是因为1991年～1993年做了大量急性感染者的研究工作，才得出这种结论。至于说抗体没有产生，我想这不会是专家的说法。

　　    问：现在的试剂会不会有查不出来的病毒亚型啊？

　　    曹韵贞：不会，什么叫亚型，HIV是有3个结构基因组成的，主要有一个叫L，叫表面基因，这里面有这种氨基酸的可变状，不同的氨基酸产生不同的亚型，随便你是什么亚型它总归是HIV。HIV有共性，抗体都应是阳性，抗体的试剂包罗了所有亚型。

　　    问：我于9月8日有高危行为，对方是个小姐，我没有采取措施。事后，我先后和她检查了多次，最近的一次检测，我是90天，结果阴性，用上海科华试剂双抗原夹心法检测；她是85天，阴性，用北京万泰双康原夹心法检测。请问，我能完全排除吗？需要不需要做确诊检测？

　　    曹韵贞：我想可以排除，因为国内的这些试剂都是经过鉴定的，相对来说是比较可靠的。如果初筛阴性的话，确认什么呢？所谓初筛是用总的病毒的抗体来检测。所谓确认是用抗原做在特殊的纸上，是一条一条不同分子量的抗原在那个地方，抗体通过时能够起反应了，就一条一条比较明显地出来了，这个叫确认。你连初筛都没有，确认什么呢？不需要。

　　    问：我在地坛医院做过病毒载量，在深圳做过PCR，都没有问题。有的网站说这些检查不准确，不作为常规检查。到底如何才能彻底确定？

　　    曹韵贞：艾滋病检测窗口期PCR是不可做诊断的，这点是可肯定的。诊断就是抗体，如果要做病毒载量是为了急性期，抗体还没有出现可以做病毒载量，为了做治疗，为了解病情做病毒载量。

　　    问：高危性行为后2周、4周HIV抗体检测阴性，可以排除HIV感染吗？

　　    曹韵贞：一个半月左右即可排除了。要看你两周是怎么算，我碰到一个病人，他跟我说是一个月以前，有过高危行为，但是我仔细问他3天前还有高危行为。

　　    问：相当少的人要到6个月才可以查出抗体（资料来源美国哥伦比亚大学教授）

　　    曹韵贞：艾滋病检测窗口期我没有看见过这个，如果你愿意跟我讨论，你把文献传给我都可以，因为我们说的是绝大多数，你说有个别那样，确实有特殊情况，现在全世界查出有七个人血里没有抗体，尿里有抗体。正在研究，全世界几千万人的感染，只有七个人是这样，你拿七个人做代表吗？少数的一个两个就不能把它作为一个常规的东西来看。

　　    问：HIV抗体检测假阴性的概率有多大？3个月检测结果阴性还用再做第二次检测吗？

　　    曹韵贞：艾滋病检测窗口期假阴性的概率是很低的，因为我们用的检测试剂阳性在99%以上，假阳性应该是1%以下，很少，做两次不可能两次都是假阴性，我觉得假阴性的机率很小。艾滋病检测窗口期

　　Detect AIDS window period

　　Recently there is lot of people call to ask about the window period Detect AIDS problem, but there is much information about the inconsistency of the information, and some say a month, some say 3 months, some say 6 months and so on. Lot of people 2 months, 3 months to do negative HIV antibody test results, with great difficulty lifted the idea concerns, all of a sudden see that there is information or listen to others to wait 6 months to do testing, psychological burden also increased, almost every day playing CONSULTATION to telephone inquiries, such as described再熬3 months, feel the spirit of stress and so it is hard to bear. To this end, our special will be our country well-known AIDS expert Professor Cao Yunzhen reproductive health in China Internet and Internet users communicate regarding AIDS testing questions and answers are summarized below:

　　     Cao Yun-Zhen: Detect the window period of HIV AIDS virus (HIV) to enter the high-speed replication of the human body, causing a so-called acute viremia. HIV violations are CD4 cells, or lymphatic system, so there will be a similar mononucleosis symptoms, the symptoms often are 7 to 12 days, so the acute clinical stage of AIDS at 2 weeks. Can occur within two weeks mononucleosis symptoms, including sore throat, slight fever, skin has spots, neck lymph nodes or more or a little back pain and so on. Generated from the virus after contact with cellular and humoral immunity, antibody at 2 ~ 6 weeks after the elections, most people if there is infection, then perhaps one and a half months after the antibody alone, and it will not be extended to 3 months, 6 months, 1年.

　　     Cao Yun-Zhen: I do not know why this window of time changed, This is a scientific conclusion, the 4 ~ 6 weeks after long-term are a lot of our case may be, this is a scientific conclusion. There are also individual circumstances, saying that infection is not clear when he is not after infection to check one week, two weeks go investigation. We are talking about the so-called 4 ~ 6 weeks are combined with a large number of cases out of a scientific conclusion.

　　     Q: Why many experts say the window period of 6 months, some say that has not yet produced antibodies. AIDS Forum

　　     Cao Yun-Zhen: Detect window AIDS experts are now too many, as a physician, said of the antibody 3 months, 6 months I did not advice, not all people have seen patients with acute, nor are all of Each of acute patients are a lot of checks. Since I was in 1993 ~ 1991 to do a lot of acute infection of the research work, then came to this conclusion. As for the view that antibodies did not produce, I think this will not be experts.

　　     Q: Will the reagents have not check out the virus subtype ah?

　　     Cao Yun-Zhen: No, what is subtype, HIV is composed of three structural genes, mainly there is a man named L, is called the surface gene, which has this amino acid inside the variable-shaped, different subtypes have different amino acid, just what you are it is always subtype HIV. HIV have in common, should be positive for antibodies, reagents include antibodies of all subtypes.

　　     Q: I have September 8 high-risk behavior, the other is a young lady, I do not have to take measures. After that, I have checked with her on many occasions, most recently testing, I was 90 days, resulting in negative, the use of reagents Haike Howard double antigen sandwich assay; she was 85 days, negative, with Beijing Thomas Kamm double sandwich assay. I would like to ask, I can entirely rule out吗? Do not need to do necessary diagnosed Detected?

　　     Cao Yun-Zhen: I want to be ruled out, because these reagents have been identified, relatively speaking, are more reliable. If the screening-negative, then, confirm what? The so-called screening is the total of the virus to detect antibodies. The so-called antigen recognition is special to do at the paper, is a molecular weight of a different place in that the antigen, antibodies can react when it was passed, and on a more obvious one out, this is called confirmation. Screening you have not even confirmed what? Do not need.

　　     Q: At my hospital did Ditan viral load, made in Shenzhen PCR, do not have any problem. Some website said that these inspections are not accurate, not as a routine examination. How in the end can be completely sure?

　　     Cao Yun-Zhen: Detect the window period of AIDS is not to do PCR diagnosis, this point is positive. Diagnosis is the antibody, if the viral load is to be done for the acute phase, antibody also can not make viral load, in order to make treatment for the condition know to do viral load.

　　     Q: high-risk sexual behavior after two weeks, four weeks negative HIV antibody test, HIV infection can be ruled out吗?

　　     Cao Yun-Zhen: about a month and a half can be ruled out. Depends on how you are counting two weeks, I get a sick, he told me a month ago, and there was a high-risk behavior, but I carefully ask him 3 days ago have high-risk behavior.

　　     Q: very few people want to six months before they are detected antibodies (Source American professor at the University of Colombia)

　　     Cao Yun-Zhen: AIDS Detected window I did not see this, if you are willing to discuss with me, you put me to the literature can be, because we are talking about are the majority, there is individual as you said, there are special circumstances, and now the whole identified seven individuals the world has no antibodies in blood, urine, there are antibodies. Are studying all over the world, tens of millions of people infected, only seven individuals this is the case, you get to do on behalf of seven individuals吗? A minority can not be both as a conventional point of view of things.

　　     Ask: HIV antibody detection probability of false-negative What are the odds? 3 month negative test results also do the second Detect吗?

　　     Cao Yun-Zhen: AIDS Detected window false negative probability is very low, because our detection reagent used at more than 99% positive, false positive is 1% or less, few, two are impossible to make two false-negative, I think a very small chance of false negative results. Detect AIDS window period