研究背景：愛滋病毒與梅毒此兩種疾病隨著病程進展易引發神經系統疾病，雙重感染下會增加愛滋病毒傳播風險。多數研究探討愛滋病合併梅毒之發生率與危險性行為間之相關因素，對於兩者交互作用所引發神經系統疾病分類缺乏一致性，且無長期性全國調查數據；造成神經系統疾病的相關影響因素則有不同論點及爭議。
研究目的：本研究分析2000年至2010年愛滋病毒感染者合併梅毒造成神經系統功能疾病盛行率及發生率，探討愛滋病毒感染者有無合併梅毒感染出現神經系統疾病之差異及相關影響因素。
研究方法：採世代研究法，擷取全民健保資料庫所提供門診處方治療明細檔(CD)、門診處方醫令明細檔(OO)、住院處方及治療明細檔(DD)進行回溯性資料分析，分析2000年至2010年愛滋病毒感染者有無合併梅毒引發神經系統疾病之盛行率及發生率，以Cox proportional hazard分析造成神經系統疾病相關影響因素。
結果：愛滋病毒感染者神經系統疾病盛行率為10.07%，合併梅毒感染者盛行率高於單一愛滋病毒感染者(10.99% vs. 9.76%)。神經系統疾病發生率為12.69人/1,000人年，愛滋病毒合併梅毒之神經系統疾病發生率高於單一愛滋病毒感染者(16.14人/1,000人 v.s 11.94人/1,000人年)。影響愛滋感染者引發神經系統疾病因素為梅毒感染(Ajusted Harzard Ratios: 1.448, 95%CI: 1.211-1.731, p-value: <0.001)、老化(55-64歲AHR: 2.299, 95% CI: 1.533- 3.447, p-value: <0.001;≧65歲AHR: 3.205, 95%CI: 1.875-5.469, p-value: <0.001)、曾診斷物質濫用(AHR: 1.341, 95%CI: 1.048-1.718, p-value: 0.0199)及伺機性感染者(AHR: 1.686, 95%CI: 1.329-2.138, p-value: <0.001)、無定期回診(AHR: 1.329, 95%CI: 1.096-1.612, p-value: 0.0038)及服用HARRT藥物(AHR: 0.791, 95%CI: 0.714-0.878, p-value: <0.001)。
結論：愛滋病毒合併梅毒罹患神經系統疾病風險相較單一病毒感染者高出1.4倍，建議衛生單位提升愛滋病毒與梅毒篩檢率，醫療院所照護愛滋病毒合併梅毒感染、中老年人(≧45歲)、曾診斷物質濫用及伺機性感染、HARRT遵循率低及無定期回診者，每年定期評估神經生理症狀神經學相關檢驗，以降低神經系統疾病之發生。

Background: Patients infected with human immunodeficiency virus (HIV) or syphilis are prone to neurological disorders as their disease progression, and coinfection can increase the risk of transmission. Most studies have investigated the relationship between the incidence of coinfection and risk sexual behaviors; however, no long-term national cohort study has investigated the neurological diseases caused by infections of both diseases. Therefore, the factors associated with neurological diseases remain debatable.
Objective: This study analyze the prevalence and incidence of neurological
diseases in patients with HIV-syphilis coinfection from 2000 to 2010, investigating the differences in and relevant factors of the increasing risk of neurological diseases.
Methods: We collected data from outpatient, inpatient, and medical order files by using the National Health Research Institute (NHRI) to perform a retrospective data analysis. We analyzed the prevalence and incidence of HIV-associated neurological diseases in patients with and without syphilis coinfections, using a Cox proportional hazard to analyze the risk of and relevant factors for neurological diseases.
Results: The prevalence rate of neurological diseases among HIV-infected patients is 10.07%. With the added prevalence rate of syphilis among HIV-infected patients, the rate is higher than that of patients with only HIV (10.99% v.s 9.76%). The incidence rate of neurological diseases among HIV-infected patients is 12.69 people per 1000 person-year. The incidence rate neurological disease in patients with both HIV and syphilis is higher than that in mono-HIV infected patients (16.14 people per 1000 person-year v.s 11.94 people per 1000 person-year). The causes of neurological diseases among HIV-infected patients were syphilis infection (AHR: 1.448; 95% CI: 1.211-1.731, p-value: < .001), aging (55-64 AHR: 2.299; 95% CI: 1.533- 3.447, p-value: < .001; ≧65 AHR: 3.205, 95% CI: 1.875- 5.469, p-value: < .001), substance abuse (AHR: 1.341; 95% CI: 1.048-1.718, p-value: .0199), opportunistic infection (AHR: 1.686; 95% CI: 1.329-2.138, p-value: < .001), irregular re-visit patients(AHR: 1.329; 95% CI: 1.096-1.612, p-value: .0038) and HARRT medication(AHR: 0.791, 95%CI: 0.714-0.878, p-value: < .001).
Conclusions: The risk of dual HIV and syphilis neurological diseases is 1.4 times higher than that single virus infection. We suggest that health units increase their rates of HIV and syphilis screening. Hospitals should focus on patients infected with HIV and syphilis, substance abuse, those with opportunistic infections, a low following rate of HARRT, older patients (ages≧45), and those with irregular follow-ups. Hospitals should annually monitor neurology related tests to avoid incidences of neurological diseases.

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