Effect of HIV and Antiretroviral Treatment on Auditory Functions

Abstract

Introduction Numerous studies have evaluated auditory functions in human immunodeficiency virus (HIV) patients; however, these studies had a few major limitations in terms of methodology as they used mainly evoked audiometry although this method is expensive, time consuming and not widely available. Therefore, we conducted a study in naïve HIV subjects with routine audiometry.

Objective To determine the effect of HIV and of the drugs used to treat it on the auditory functions.

Methods A prospective observational study was conducted in a medical college with 25 naive HIV-seropositive patients for over a year. Pure tone audiometry (250–8,000 Hz) and CD4 T-lymphocyte count were performed at the time of enrollment and 6 months after commencement of highly active antiretroviral treatment.

Results The subjects had increased hearing thresholds at high frequencies (4 KHz and 8KHz) in both ears at the time of enrollment that persisted at the same level (p > 0.05) on follow-up at 6 months. None of the subjects had any other otological symptom during the 6 months of observation. Seven subjects had sensorineural hearing loss in one or both ears at 0 and 6 months. These observations did not show any significant difference on Wilcoxon-signed-rank test. Spearman correlation did not find a significant correlation (p > 0.05) between CD4 T-lymphocyte counts and pure tone audiometry during the study.

Conclusion We found high-frequency hearing loss in all subjects with no relation with highly active antiretroviral therapy (HAART) and severity of the disease. This study advocates hearing assessment with pure tone audiometry in HIV subjects so that intervention can be initiated in a timely manner.

Keywords

HIV - hearing loss - audiometry - CD4 T-lymphocyte count

• References

• 1 Hausler R, Vibert D, Koralnik IJ, Hirschel B. Neuro-otological manifestations in different stages of HIV infection. Acta Otolaryngol Suppl 1991; 481: 515-521
• 2 Pappas Jr DG, Chandra Sekhar HK, Lim J, Hillman DE. Ultrasructural findings in the cochlea of AIDS cases. Am J Otol 1994; 15 (04) 456-465
• 3 Bankaitis A, Schountz T. HIV-related ototoxicity. Semin Hear 1998; 19 (02) 155-163
• 4 Simdon J, Watters D, Bartlett S, Connick E. Ototoxicity associated with use of nucleoside analog reverse transcriptase inhibitors: a report of 3 possible cases and review of the literature. Clin Infect Dis 2001; 32 (11) 1623-1627
• 5 Schouten JT, Lockhart DW, Rees TS, Collier AC, Marra CM. A prospective study of hearing changes after beginning zidovudine or didanosine in HIV-1 treatment-naïve people. BMC Infect Dis 2006; 6: 28
• 6 van der Westhuizen Y, Swanepoel W, Heinze B, Hofmeyr LM. Auditory and otological manifestations in adults with HIV/AIDS. Int J Audiol 2013; 52 (01) 37-43
• 7 Maro II, Moshi N, Clavier OH. , et al. Auditory impairments in HIV-infected individuals in Tanzania. Ear Hear 2014; 35 (03) 306-317
• 8 Khoza K, Ross E. Auditory function in a group of adults infected with HIV/AIDS in Gauteng, South Africa. S Afr J Commun Disord 2002; 49: 17-27
• 9 Sooy CD, Gerberding JL, Kaplan MJ. The risk for otolaryngologists who treat patients with AIDS and AIDS virus infection: report of an in-process study. Laryngoscope 1987; 97 (04) 430-434
• 10 Torre III P, Zeldow B, Hoffman HJ. , et al; Pediatric HIVAIDS Cohort Study. Hearing loss in perinatally HIV-infected and HIV-exposed but uninfected children and adolescents. Pediatr Infect Dis J 2012; 31 (08) 835-841
• 11 Palacios GC, Montalvo MS, Fraire MI, Leon E, Alvarez MT, Solorzano F. Audiologic and vestibular findings in a sample of human immunodeficiency virus type-1-infected Mexican children under highly active antiretroviral therapy. Int J Pediatr Otorhinolaryngol 2008; 72 (11) 1671-1681
• 12 Assuiti LF, Lanzoni GM, Santos FC, Erdmann AL, Meirelles BH. Hearing loss in people with HIV/AIDS and associated factors: an integrative review. Rev Bras Otorrinolaringol (Engl Ed) 2013; 79 (02) 248-255