Auditory Impairments in HIV-Infected Children

Area of Science:

• Otorhinolaryngology
• Infectious Diseases
• Pediatrics

Background:

• Human immunodeficiency virus (HIV) infection can affect various organ systems, including the auditory system.
• Previous studies in adults suggest auditory processing deficits and reduced otoacoustic emissions in individuals with HIV.
• The impact of HIV on the auditory system in children requires further investigation.

Purpose of the Study:

• To investigate the prevalence of peripheral and central auditory system abnormalities in children with HIV compared to HIV-negative controls.
• To assess the relationship between HIV status and audiological test results, including DPOAEs, pure-tone thresholds, tympanometry, and auditory brainstem response.

Main Methods:

• A cross-sectional study involving 244 children (131 HIV+ and 113 HIV-).
• Audiological assessments included pure-tone thresholds, distortion product otoacoustic emissions (DPOAEs), tympanometry, gap detection tests, and auditory brainstem response.
• Data from ears with abnormal tympanograms were excluded to focus on cochlear and retrocochlear function.

Main Results:

• HIV+ children had a higher incidence of abnormal tympanograms and a history of ear drainage.
• While pure-tone thresholds and auditory brainstem response latencies did not significantly differ, HIV+ children showed reduced DPOAE levels at multiple frequencies.
• A higher proportion of HIV+ children exhibited hearing loss exceeding 25 dB HL in the better ear.

Conclusions:

• HIV+ children frequently present with middle ear damage, which can confound the assessment of direct HIV effects on hearing.
• Reduced DPOAE magnitudes in HIV+ children suggest peripheral auditory system dysfunction, potentially related to cochlear effects or efferent pathway involvement.
• Antiretroviral drug ototoxicity is considered an unlikely cause for the observed DPOAE reductions.