Abstract: Objective To analyze the clinical constitutions of fundus lesions in AIDS patients combined with syphilis. Design Retrospective case series. Participants 395 AIDS patients were treated in Beijing Youan Hospital from 2012 to 2019. Methods All AIDS patients were divided into AIDS group and AIDS with syphilis group according to whether they combined with syphilis or not. All patients were examined for best corrected vision acuity (BCVA), slit lamp, intraocular pressure, mydriatic fundus examination and color fundus photography. The history of AIDS and HAART treatment were recorded. Syphilis rapid plasma reagin test (RPR)，blood CD4+T cells, HIV-RNA load and CMV-DNA were tested. Compare the ocular and general conditions between the two groups. Main Outcome Measures BCVA, anterior segment reaction, funus lesion, HAART statues, blood CD4+T cell count, HIV-RNA load and CMV-DNA load. Results 266 patients in AIDS group, 163 patients (61.3%) with abnormal fundus, in which, 149 cases (91.4%) were males, 66 cases (40.5%) with HIV related microvascular retinopathy, 94 cases (57.7%) with cytomegalovirus retinitis, and the median CD4+T cell count was 27/μl. There were 129 AIDS patients with syphilis, 93 cases (72.1%) had abnormal fundus (P=0.035), 92 cases (P=0.014) were male, 40 (31.0%) with HIV related microvascular retinopathy, 26(20.2%) with syphilis related fundus changes, 25(19.4%) with cytomegalovirus retinitis. In which, 23 cases had positive reaction to anterior segment (P=0.010), 63 cases (67.7%) had central fundus lesion (P=0.040), and the median number of CD4+T cells was 33.5 /μl (P=0.007), which was significantly higher than that of AIDS group. Conclusion The incidence rate of fundus lesions and number of blood CD4+T cells in AIDS combined syphilis group was significantly higher than that in group AIDS.

Key words: AIDS, syphilis , retinopathy