Kunkel Jan, Schürmann Dirk, Pleyer Uwe, Rüther Klaus, Kneifel Christiane, Krause Lothar, Reichert Manuela, Ignatius Ralf, Schneider Thomas
Department of Medicine I, Gastroenterology, Infectious Diseases & Rheumatology, Charité-University Medicine Berlin, Campus Benjamin Franklin, Hindenburgdamm 30, 12200 Berlin, Germany.
J Infect. 2009 Jan;58(1):32-6. doi: 10.1016/j.jinf.2008.11.004. Epub 2008 Dec 10.
To detect the prevalence of HIV-co-infection in patients with ocular syphilis and to compare ocular syphilis in HIV-positive and -negative patients.
24 consecutive patients treated for ocular syphilis at our hospital between 1998 and 2006 were evaluated retrospectively. Patients' characteristics, laboratory results (including syphilis serology, HIV status, CSF examination), major ophthalmologic finding, treatment and course were assessed. Data of HIV-positive and -negative patients were compared.
Of the 24 patients with ocular syphilis, 11 were co-infected with HIV. Notably, the HIV-infection had previously been unknown in 7 of the 11 HIV-positive patients. 6 of these were in an early disease stage (CDC category A). Clinical and laboratory findings did not differ between HIV-positive and -negative patients except for the C-reactive protein (CRP), which was significantly higher in HIV-infected patients.
Ocular syphilis led to new diagnosis of HIV-infection in an unexpectedly high number of patients, which emphasises that patients with ocular syphilis must be screened for HIV-co-infection. According to our study the expected benefit is high because most of the patients newly diagnosed with HIV had high CD4(+) cell counts. These patients can be monitored and treated before the development of AIDS.
检测眼部梅毒患者中HIV合并感染的患病率，并比较HIV阳性和阴性患者的眼部梅毒情况。
对1998年至2006年间在我院接受眼部梅毒治疗的24例连续患者进行回顾性评估。评估患者的特征、实验室检查结果（包括梅毒血清学、HIV状态、脑脊液检查）、主要眼科检查发现、治疗及病程。比较HIV阳性和阴性患者的数据。
24例眼部梅毒患者中，11例合并HIV感染。值得注意的是，11例HIV阳性患者中有7例之前未知感染HIV。其中6例处于疾病早期（疾病控制中心A类）。除C反应蛋白（CRP）外，HIV阳性和阴性患者的临床和实验室检查结果无差异，HIV感染患者的CRP显著更高。
眼部梅毒导致意外高比例的患者被新诊断出HIV感染，这强调必须对眼部梅毒患者进行HIV合并感染筛查。根据我们的研究，预期获益很高，因为大多数新诊断出HIV的患者CD4(+)细胞计数较高。这些患者可在艾滋病发展之前进行监测和治疗。
