目的：探讨获得性免疫缺陷综合征（acquired immune deficiency syndrome, AIDS）合并巨细胞病毒性视网膜炎（cytomegalovirus retinitis，CMVR）抗病毒治疗后眼内液特征，为临床优化治疗方案、评估疗效提供参考。方法：回顾性分析2018年11月—2024年12月广州医科大学附属市八医院收治的49例AIDS合并CMVR患者的临床资料，按治疗方式的不同分为全身用药组（n=23，30眼）及联合组（n=26，30眼），全身用药组予静脉滴注膦甲酸钠全身抗病毒治疗，联合组在此基础上加用玻璃体腔注射更昔洛韦，比较两组的眼内液特征。结果：治疗后两组眼内液CMV核酸载量、白细胞介素（interleukin, IL）-6、IL-8、IL-10、血管内皮生长因子（vascular endothelial growth factor, VEGF）、碱性成纤维细胞生长因子（basic fibroblast growth factor，BFGF）、血管细胞黏附分子（vascular cell adhesion molecule, VCAM）水平低于治疗前，且联合组低于全身用药组（P＜0.05）；治疗前后两组均未检出单纯疱疹病毒（herpes simplex virus, HSV）、水痘-带状疱疹病毒（varicella-zoster virus, VZV）、爱泼斯坦-巴尔病毒(epstein-barr virus, EBV)、人疱疹病毒6型（human herpesvirus 6, HHV-6）。Spearman秩相关分析显示，房水中CMV核酸载量与IL-6、IL-8、IL-10、VEGF、BFGF、VCAM均呈正相关（P＜0.05）。结论：AIDS合并CMVR患者经全身联合局部抗病毒的疗效更佳，可更显著降低眼内液CMV核酸载量及相关炎症、生长因子水平，且房水CMV核酸载量与上述细胞因子水平呈正相关系。

Objective: To investigate the intraocular fluid characteristics of acquired immunodeficiency syndrome (AIDS) complicated with cytomegalovirus retinitis (CMVR) after antiviral treatment. Method: A retrospective analysis was conducted on the clinical data of 49 patients with AIDS and concomitant CMVR admitted to our hospital from November 2018 to December 2024. They were divided into a control group (n=23, 30 eyes) and a combination group (n=26, 30 eyes) according to different treatment methods. The control group received systemic antiviral treatment with intravenous sodium phosphonate, while the combination group received intravitreal injection of ganciclovir (GCV) on this basis. The intraocular fluid characteristics of the two groups were compared. Result: After treatment, the levels of CMV nucleic acid load, interleukin-6, IL-8, IL-10, vascular endothelial growth factor (VEGF), basic fibroblast growth factor (BFGF), and vascular cell adhesion molecule (VCAM) in the intraocular fluid of both groups were lower than before treatment, and the combined group was lower than the control group (P<0.05); No HSV was detected in both groups before and after treatment EBV、VZV、HHV-6。 Spearman correlation analysis showed that the CMV nucleic acid load in aqueous humor was positively correlated with IL-6, IL-8, IL-10, VEGF, BFGF, and VCAM (P<0.05). Conclusion: AIDS patients with CMVR showed better efficacy after systemic and local antiviral treatment, and exhibited significant decreases in CMV nucleic acid load and related cytokines in aqueous humor.

目的：分析染色体外环状DNA（extrachromosomal circular DNA, eccDNA）的分子特征及潜在功能，初步探索eccDNA在合并人类免疫缺陷病毒（human immunodeficiency virus, HIV）感染患者的白内障发病过程中的作用机制。方法：收集4例合并HIV感染的并发性白内障（complicated cataract, CC）患者及性别、年龄与之匹配的4例年龄相关性白内障（age-related cataract, ARC）患者晶状体囊膜，通过提取、滚环扩增及circle-seq对eccDNA进行全长测序，分析比较合并HIV感染的CC患者及ARC患者之间晶状体囊膜eccDNA的数量、长度分布、基因组元件分布及eccDNA相关差异基因功能富集情况。结果：合并HIV感染的CC患者晶状体囊膜中eccDNA数量较ARC患者增多，鸟嘌呤（guanine, G）和胞嘧啶（cytosine，C）碱基所占的比例（GC含量）较ARC患者减少。在CC患者及ARC患者中，eccDNA的长度在1 200 ~1 800 bp均分布最多，CC患者在2 000~2 200 bp之间呈现另一部分高峰，ARC组则在此区间eccDNA丰度极低。CC患者eccDNA来源基因组元件在CpG岛占比低于ARC组。 CC患者组eccDNA差异基因富集的通路多与钙信号通路、Apelin信号通路及cGMP-PKG信号通路相关。结论：合并HIV感染的CC患者与ARC患者晶状体囊膜eccDNA的分子特征存在差异，提示eccDNA可能通过基因表达调控晶状体前囊膜代谢功能影响CC的发生、发展。

Objective: To perform full-length sequencing of extrachromosomal circular DNA (eccDNA) in the lens capsule of patients with human immunodeficiency virus (HIV)-infected complicated cataract (CC) and age-related cataract (ARC). The aim is to analyze the molecular characteristics and potential functions of eccDNA and initially investigate the mechanism by which eccDNA contributes to the pathogenesis of cataract related to HIV infection. Methods: Lens capsules were collected from 4 CC patients who were co-infected with HIV and from ARC patients matched for gender and age. The eccDNA was sequenced following a process that included extraction, rolling circle amplification, and circle-seq. We then analyzed and compared the number, length distribution, genomic element distribution, and enrichment of differential gene functions associated with eccDNA in the lens capsules of CC patients co-infected with HIV and ARC patients. Results: The number of eccDNA molecules in the lens capsule of CC patients co-infected with HIV was significantly higher than that in ARC patients, while the GC content was lower.. In both CC and ARC patients, the majority of eccDNA lengths felll within the range of 1200 to 1800 bp. However, CC patients exhibited an additional peak between 2000 and 2200 bp, where the abundance of eccDNA in the ARC group was extremely low. Regarding genomic elements derived from eccDNA, the proportion in CC patients was lower than that in the ARC group within CpG islands. The pathways associated with differential gene enrichment of eccDNA in CC patients were primarily related to the calcium signaling pathway, Apelin signaling pathway, and cGMP-PKG signaling pathway. Conclusions: There are notable differences in the molecular characteristics of lens capsule eccDNA between CC patients with HIV infection and ARC patients.These finding suggest that eccDNA may influence the onset and progression of CC by regulating the metabolic functions of the anterior lens capsule through gene expression.