Peripheral Auditory Function in Tanzanian Children Living With HIV With Clinically Normal Hearing

Area of Science:

• Pediatric infectious diseases
• Neuroscience
• Audiology

Background:

• Adults with HIV exhibit reduced distortion product otoacoustic emissions (DPOAEs) despite normal audiometry.
• The impact of HIV on auditory function in children, particularly subclinical deficits, remains largely unknown.
• Potential auditory deficits in children living with HIV (CLWH) could affect developmental trajectories.

Purpose of the Study:

• To compare DPOAEs and auditory brainstem responses (ABRs) in HIV-infected children versus age- and sex-matched HIV-negative children with normal audiometry.
• To investigate early auditory system changes in CLWH.

Main Methods:

• A cohort study involving 340 Tanzanian children aged 3-9 years with normal hearing.
• Distortion product otoacoustic emissions (DPOAEs) and click-evoked auditory brainstem responses (ABRs) were measured.
• Data were collected over approximately 2.2 sessions per participant and analyzed between March 2020 and January 2022.

Main Results:

• HIV status was associated with significantly lower DPOAE amplitudes at 6 and 8 kHz and lower ABR wave V amplitudes in the right ear.
• Specifically, DPOAE amplitudes were 1.4 dB to 3.8 dB lower, and ABR wave V amplitudes were 0.28 μV lower in CLWH.
• No significant differences were found between groups in age, static immittance, or air-conduction thresholds.

Conclusions:

• CLWH demonstrate slightly, yet reliably, lower DPOAEs and ABR wave V amplitudes than HIV-negative controls.
• These findings suggest an early association between HIV infection/treatment and auditory pathway function in children.
• Subclinical auditory changes warrant monitoring of both auditory function and developmental outcomes in CLWH.