Persistently False Negative Antibody Response in a HIV-Infected Patient: A Case Report

愛滋病毒感染者持續偽陰性抗體反應：病例報告

黃俊凱(Chun-Kai Huang)

《南臺灣醫學雜誌》 13卷2期 (2017/12) Pp. 80-85

https://doi.org/10.6726/MJST.201712_13(2).0004

摘要

Antibody detection by enzyme immunoassay ( EIA ) is primarily the screening test in the diagnosis of human immunodeficiency virus (HIV) infection. However, the result by EIA method could be negative during the window period, and another diagnostic tools should be applied to avoid any delay or miss in the diagnosis of HIV infection. Both viral load and p24 antigen tests could be used to shorten the window period for early HIV diagnosis. We report an unusual case of HIV infection with multiple opportunistic infections and persistently negative antibody response. Late stage of acquired immunodeficiency syndrome (AIDS) or acute HIV infection, leading to lack of adequate detectable antibody, could be the possible causes of negative HIV test. In conclusion, use of anti-HIV Combo assay or viral load in highly suspicious patients is the key for early diagnosis of HIV.

關鍵字

HIV antibody ； enzyme immunoassay ； Combo assay ； false negative

並列摘要

愛滋病毒的篩檢主要是以免疫酵素法來偵測抗體，然而在空窗期時會測不出陽性反應，需要運用其他診斷工具以免延誤或錯失診斷。病毒量及p24抗原的檢測可以縮短空窗期以獲得早期診斷。在此我們提出一罕見病例，是愛滋病毒感染合併多種伺機性感染及持續偽陰性抗體反應。愛滋病晚期或是急性愛滋病毒感染，導致缺少產生足夠的抗體是造成持續陰性抗體反應的原因。總之，針對高度懷疑愛滋病的病人，使用複合檢驗或病毒量是早期診斷的不二法門。

並列關鍵字

愛滋抗體 ； 免疫酵素法 ； 複合檢驗 ； 偽陰性