HIV/AIDS and auditory function in adults: the need for intensified research in the developing world

This article reviews published research on auditory function in HIV-infected adults, while also highlighting the need for intensified research on this topic in Africa. It begins with an introduction to the effects of HIV disease and treatment on the auditory system, and so highlights the need to put auditory function in adults with HIV or AIDS on the healthcare and research agenda in developing countries. The discussion refers to this population in regard to: published prevalence and incidence data related to auditory manifestations; most prevalent types of auditory manifestations and hearing loss; degree, configuration, and symmetry of the hearing loss; types of onset of hearing loss; and the proposed direct and indirect causes of auditory manifestations in HIV disease. Finally, the possible effects of HIV/AIDS drug treatments on the auditory system, as an indirect cause of hearing loss, are also discussed. A review of the literature revealed that auditory manifestations in adults with HIV or AIDS are heterogeneous in nature and are possibly due to various causes. Auditory presentations, including hearing loss, tinnitus and vertigo (in varied combinations) can occur with hearing loss, which includes conductive, mixed, sensorineural, and central types of hearing loss. The severity of hearing loss can range from mild to profound, occurring either unilaterally or bilaterally, with the types of onset including sudden or gradual and progressive. The varied causes of hearing loss include HIV infection or AIDS illness as a primary cause, opportunistic infections, and antiretroviral treatments. The studies discussed are mainly from developed countries where the presentation and management of HIV and AIDS can be different to that in developing countries because the context is different. This suggests a need for more research in this area since the numbers of adults living with HIV or AIDS in developing countries like South Africa is relatively high.