免疫印迹和聚合酶链反应诊断 HIV 阳性和 HIV 阴性患者的眼部梅毒和神经梅毒。
Immunoblot and Polymerase Chain Reaction to Diagnose Ocular Syphilis and Neurosyphilis in HIV-positive and HIV-negative Patients.
机构信息
Ophthalmology, Faculty of Medicine and Health Sciences, Stellenbosch University , Cape Town, South Africa.
Medical Microbiology, University Medical Center Utrecht , Utrecht, Netherlands.
出版信息
Ocul Immunol Inflamm. 2020 Oct 2;28(7):1049-1055. doi: 10.1080/09273948.2019.1698753. Epub 2020 Jan 16.
: To evaluate immunoblot (IB) and polymerase chain reaction (PCR) to diagnose ocular- and neurosyphilis. : Prospective cross-sectional study. Aqueous humor (AH) and cerebrospinal fluid (CSF) samples were tested for treponemal DNA or antibodies to treponemal antigens. : Thirteen of 106 cases had positive syphilis serology of which 69.2% were HIV+ (median CD4+ = 181 cells/µL). Four cases met CDC criteria for neurosyphilis (3 confirmed, 1 probable) and 2 additional cases required neurosyphilis treatment according to UpToDate algorithms. All AH and CSF samples tested PCR negative. Five cases were CSF IB+ and 3 cases AH IB+. Using our classification, eight patients had confirmed neurosyphilis, one had probable neurosyphilis, three had confirmed ocular syphilis and nine had probable ocular syphilis. : Our findings suggest that IB of AH and CSF provides additional evidence to diagnose ocular and neurosyphilis and allows us to classify them as probable or confirmed.
: 评估免疫印迹（IB）和聚合酶链反应（PCR）在诊断眼和神经梅毒中的应用。 : 前瞻性横断面研究。对房水（AH）和脑脊液（CSF）样本进行梅毒螺旋体 DNA 或针对梅毒螺旋体抗原的抗体检测。 : 在 106 例病例中，有 13 例梅毒血清学阳性，其中 69.2%为 HIV+（中位数 CD4+ = 181 个/µL）。4 例符合 CDC 神经梅毒标准（3 例确诊，1 例可能），根据 UpToDate 算法，另外 2 例需要神经梅毒治疗。所有 AH 和 CSF 样本的 PCR 检测均为阴性。5 例 CSF 的 IB 检测阳性，3 例 AH 的 IB 检测阳性。根据我们的分类，8 例患者确诊为神经梅毒，1 例可能为神经梅毒，3 例确诊为眼部梅毒，9 例可能为眼部梅毒。 : 我们的研究结果表明，AH 和 CSF 的 IB 提供了额外的证据来诊断眼和神经梅毒，并允许我们将其分类为可能或确诊。
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