【温暖姐】【英文哥】麻烦进来看看我急性期的症状
这段时间一直在苦苦等待检查的日子，身心憔悴，我带套小姐口交和阴交，套子完好，没有任何症状，可可可可可。。。。。。。我的这段时间一直在恐艾时间，一直没心情刷牙，前天下午嘴里苦涩的厉害就去刷牙了，随后舌头开始有一种麻麻发热的感觉，昨晚和前天晚上熬夜的时候舌头中间麻麻发热的感觉越明显，请问我这算不算急性期啊？。。。我加一了个艾滋病群，里面的感染者也有说有我这样的症状啊【摘要】 目的 比较阴道分泌物和血清样品HIV抗体检测结果,探讨阴道分泌物样品检测HIV抗体的可行性。方法 应用血清学方法,对70例阴道分泌物与血清配对样品进行HIV抗体检测。比较阴道分泌物与血清样品的阳性符合率、阴性符合率及30例阴道分泌物与血清HIV抗体阳性配对样品的含量、WB抗原带型。结果 70例阴道分泌物与血清配对样品的阳性符合率、阴性符合率均为100%。30例阴道分泌物样品的HIV抗体阳性含量低于血清样品的HIV抗体阳性含量(P<0.01)。WB实验显示,与阳性血清配对的阴道分泌物样品至少出现gp160和p 24两条带型。结论 阴道分泌物可以作为HIV抗体检测的实验样品。对妇科女性生殖道感染患者的HIV筛查,有其重要的应用价值。
【关键词】 阴道分泌物与血清配对样品;HIV抗体;HIV筛查
文章编号：1003-1383(2008)04-0379-02中图分类号：R 512.91 文献标识码：A
Comparison of result of HIV antibody in 70 vaginal secretion and serum matched samples
HUANG Weitong1，HUANG Wei1，QIN Yuhua1，HUANG Aimin2，ZHANG Liang1，DENG Qiaoying1，ZENG Xiansheng1，WEI Hongwei2
(1.Laboratory Department,2.Departments of Obstetrics and Gynecology,YoujiangMedical College for Nationalities,Baise,533000,China)
【Abstract】 Objective To evaluate the feasibility of detecting HIV antibody in vaginal secretion by comparing the results of vaginal secretion and serum samples of HIV antibody.
Methods HIV antibody in 70 vaginal secretion and serum matched samples was detected. The positive consistency and negative consistency in vaginal secretion and serum,OD values and WB antigen type of 30 positive HIV antibody samples were compared.Results The positive and negative relative coincident rate of 70 vaginal secretion and serum matched samples was 100%. In general analyzing, HIV antibody quantities of 70 vaginal secretion samples was lower than that of serum samples. Vaginal secretion samples matched positive serum samples appeared at least two pieces belt type by WB.Con
clusion Vaginal secretion can be used for HIV antibody detection. It has some important practical values in some special population groups and under special conditions.
【Key words】 Vaginal secretion and serum matched samples；HIV antibody；Comparison
人类免疫缺陷病毒(human immunodeficiency virus,HIV)感染者体内的血液、精液、脑脊液、阴道分泌物、尿液等都含有可检测到的HIV抗体。目前，HIV实验室初筛主要是检测抗体，最常用的样品是血清或血浆，唾液或尿液有时也可作为检测样品。但阴道分泌物作为HIV抗体检测样品国内尚未见有报道。本文应用血清学方法,对70例阴道分泌物与血清配对样品进行了HIV抗体检测，并比较分析，旨在探讨阴道分泌物样品检测HIV抗体的可行性。结果报告如下。
材料和方法
1.标本采集和处理 阴道分泌物与血清配对样品被检者均为经本人同意的妇科、性病科或HIV抗体阳性者70例，年龄19岁～55岁。首先用无菌棉拭子插入宫颈口旋转3～4圈，并停留10 s，然后取出宫颈分泌物，再取阴道侧壁分泌物放入盛有1 ml无菌生理盐水试管内，将棉拭子上分泌物洗入无菌生理盐水试管后，取出棉拭子，将试管内分泌物无菌生理盐水混匀，离心10 min，取上清液放入另一支无菌试管中加盖，同时采集同一人的血清样品3 ml，两种标本一起置-20℃冰箱保存。所有样品在同一条件下检测。
2.主要试剂及结果判定标准 HIV1/2第3代ELISA，为珠海丽珠试剂有限公司生产,批号200668；WB DiagnosticHIV Blot 2•3试剂，为新加坡Genelabs公司生产,批号AE6016。结果判定样品的OD 值≥1为HIV1/2抗体阳性, <1为HIV1/2抗体阴性。
3.统计学处理 计量资料以均数±标准差(-±s)表示，组间比较采用t检验，P<0.05为有显著性差异。
结果
1.阴道分泌物与血清配对样品检测符合率比较 70例阴道分泌物与血清配对样品HIV抗体阳性和阴性符合率皆为100%，见表1。
2.阴道分泌物与血清配对HIV抗体阳性样品含量比较 30例阴道分泌物样品HIV的平均含量为7.52±2.27，血清样品HIV的平均含量为9.97±2.32，两者比较有显著性差异(t=4.132，P<0.01)。提示阴道分泌物样品的HIV抗体含量低于血清样品的HIV抗体含量。
3.阴道分泌物与血清配对HIV抗体阳性样品WB阳性结果 从WB实验反应强度来看,阴道分泌物阳性样品至少出现包膜抗原gp120和核心抗原p24 两条阳性带型，5例其它阳性带型与血清样品一样，OD值高的阴道分泌物样品与血清样品一样均出现阳性带型, 尤其是gp120和p24两条带型均为强阳性，OD值低的阴道分泌物样品，gp120和p24两条带型出现较弱(见表2、图1)。按艾滋病诊断标准，30例阴道分泌物样品与血清配对样品均可确认为HIV1型病毒感染。
讨论
从本次WB实验结果分析，70例阴道分泌物与血清配对样品阳性与阴性符合率及30例阴道分泌物与血清配对阳性样品符合率为100%，Belec L等报道采用IgG ELISA试剂盒检测HIV抗体，敏感性为97.7%,特异性为97.6%,说明阴道分泌物HIV抗体阳性检出率与血清阳性检出率结果一致性高，可作为HIV筛查的实验样品。有研究证实，通过性传播感染HIV患者不断增多，女性生殖道感染(如细菌性、淋球菌感染)者容易感染HIV，已感染HIV的性病患者也易将HIV传予他人，而且HIV在女性生殖道可单独复制，接触阴道分泌物感染HIV的危险性很高，因此宫颈、阴道炎患者是国家防治HIV的重点检测的高危人群之一，女性生殖道感染者采集阴道分泌物做常规检查的同时做HIV抗体检测，对患者为无创伤采样、简便易接受，对这些特定的高危人群和某些特殊情况下,进行艾滋病筛查有重要应用价值。本次实验对30例阴道分泌物与血清配对HIV抗体阳性样品的OD值进行比较，结果为阴道分泌物的HIV抗体含量低于血清HIV抗体含量。HIV 含量高的阴道分泌物在WB实验反应中显示p24和gp120的抗原条带为强阳性，其它抗原带型弱于血清样品， HIV含量低的阴道分泌物在WB实验反应中显示p24和gp120抗原条阳性带型较弱于血清样品。所有样品中都至少出现gp120和p24两条带型，25例阴道分泌物样品中WB显示的其它抗原阳性条带与血清样品不同,其中酶抗原p31出现最少。从实验结果进行总体分析30例阴道分泌物HIV抗体阳性者，均符合HIV1型病毒感染诊断标准。Belec L等从一名血清HIV抗体阴性被强暴妇女的阴道分泌物及阴道分泌物混合液中检测出HIV抗体阳性,为评价艾滋病感染的危险性和采取紧急预防措施提供了实验依据。可见，采集阴道分泌物样品检测HIV抗体，可为HIV筛查及个案诊断提供比较可靠的辅助诊断依据。
参考文献
中国疾病预防控制中心.全国艾滋病检测技术规范(2004年版),2004，1-7.
Belec L，Gresenguet G，Dragon MA,et al.Detection of antibodies to human immunodeficiency virus in vaginal secretions by immunoglobulin G antibody capture enzyme-linked immunosorbent assay: application to detection of seminal antibodies after sexual intercourse.
J Clin Microbiol,1994,32(5):1249.
蒋 娟.细菌性阴道病与HIV感染.国外医学•皮肤性病学分册，2001，37(4)：216-218.
Iuersen A.k.N./Attermann J./Gerstof J.-EUR.J.OBSTET.GY-NECOL,REPROD.BLOL.2004,117/2(227-235).
BelecL,MattaM,Payan C,et al.Detection ofseminalantibodies to human immunodeficiency virus in vaginal secretions after sexual intercourse: possible means of preventing the risk of human immunodeficiency virus transmission in a rape victim.JMed Viro,l，1995, 45(1):113-116.
(收稿日期：2008-05-30 修回日期：2008-07-22)
具体地址：http://www.100md.com/html/paper/1003-1383/2008/04/01.htm
为什么好多版主说阴道分泌物没危险那 新注册用户（新到会员）如何升级解除发贴限制？——————择自Medhelp，另感谢Xp609pX的翻译
I had a sex with a Prostitute. I was very careful to have safer sex. But the lady was a street walker in Hong Kong and seems the lowest class one. Most possibly she must have infected with HIV, and seems, she is not very careful too. 我在香港找过一个街边上的xj，虽然带了t，还是很害怕。
She took some KY gel and started to finger her vagina herself. Then she opened the condom and put it to the Penis and we had Protected Oral and vaginal sex. She was not careful to put on the condom. 她沾了点润滑精油然后开始在yd上抹，然后把套套给我戴上，开始kj和ydj，但是她给我戴套的时候大大咧咧的，我觉得没给我戴好。 The way she held the condom, I'm sure she contaminated inside of the condom with the vaginal fluids in her fingers. The time difference between fingering and touching the condom and put in the condom is less than 10 seconds.我很确定她把yd分泌物弄到套套上了然后给我戴的，而且这之间不超过10秒钟。
For me it is like vaginal fluids inside the condom touching tip of the penis. Because she did some deep fingering and definitely condom must have contaminated with her fluids. 我的yj接触到套套里面的yd分泌物了。她的手指插进yd很深，而且套套上明显有她的分泌物。 My questions are
1. Am I at risk of HIV or other STDs?我有没有艾滋和其他性病的风险？
2. is this like an unprotected sex or like mutual masturbation with fluid exchange 这是不是有体液交换，相当于wtxj了？
3. This happens 3 weeks ago and after two weeks I start to feel headache time to time and it lasted about a week. No rashes Fevers etc.2周后我开始头痛，持续一周，没有发烧。
4. Do I need to test? 我需要检测吗？
5. Is it ok to have unprotected sex with my wife? 现在和我妻子ml合适吗？
6. What are the chances of getting HIV from this type of Exposure? 这种情况中的几率大吗？ DR EWH的回答：
Welcome to our Forum. You are not at risk from the exposure that you describe an do not need to worry.Even among "lower class" commercial sex workers, most are not infected with HIV.Even if she was, her actions would not have put you at risk for HIV.没有风险，不需要担心。而且即便是街边的xj，携带hiv的人也很少。即使她有，她做的那些事情对你来说也是没有风险的。 As you know, condom protected sex is safe sex and that she might have transferred some of her vaginal secretions to the inside of the condom as she put it on you does not change this.HIV is not effectively transferred from person to person on hands and transfer from her genitals to her hand to the condom to you is just not a risk.戴套是安全行为。她把她的yd分泌物什么的沾在套套上，然后给你戴，这也不会改变“没有风险”的事实。hiv不通过yd--手--套--yj这个途径传播。 You do not need to worry, you really do not need to test except perhaps for your peace of mind and you do not need to worry about exposing your wife to HIV as a result of this exposure. 无需担心，如果检测结果能让你脱恐的话，那么你去作个检测吧。你和你妻子的房事不会有什么问题的。 （追问）Thank you very much Dr. Hook.
I have seen this comment in few archives, when you say it is not a risk, does it compare with a lady with HIV and very very high viral load? 我也在一些类似的帖子上看到了的同样的回答。但是如果她在窗口期，传染性很强的话，我会不会有危险呢？
I'm worrying about my headaches. 主要是头痛乏力让我太担心了。
How accurate will be 4th generation antibody test at 4 week's? will it be conclusive for this type of exposure? 4代试剂4周的抗体检测结果准确吗？ DR EWH的回答：
No risk means no risk.If she were infected, her viral load would be irrelevant.A 4 week 4th generation test that tests for both the p24 antigen of HIV and HIV antibody would be completely reliable and the results should be believed.(They will be negative).EWH 没有风险就是没有风险，跟窗口期和病毒量无关。4代试剂抗体抗原双测，4周已经非常确定了，而且我肯定结果是阴。
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