Auditory Impairments in HIV-Infected Children.
Auditory Impairments in HIV-Infected Children.
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DOI：
10.1097/aud.0000000000000276
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发表时间：
2016-07
期刊：
影响因子：
3.7
通讯作者：
Buckey JC
中科院分区：
文献类型：
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作者：
Maro II;Fellows AM;Clavier OH;Gui J;Rieke CC;Wilbur JC;Chambers RD;Jastrzembski BG;Mascari JE;Bakari M;Matee M;Musiek FE;Waddell RD;von Reyn CF;Palumbo PE;Moshi N;Buckey JC
In our cross-sectional study of human immunodeficiency virus (HIV)-infected adults, we showed lower distortion product otoacoustic emissions (DPOAEs) in HIV+ individuals compared to controls as well as findings consistent with a central auditory processing deficit in HIV+ adults on anti-retroviral therapy. We hypothesized that HIV+ children would also have a higher prevalence of abnormal central and peripheral hearing test results compared to HIV− controls. Pure-tone thresholds, DPOAEs, and tympanometry were performed on 244 subjects (131 HIV+, and 113 HIV−, subjects). Thirty-five of the HIV+, and 3 of the HIV−, subjects had a history of tuberculosis treatment. Gap detection results were available for 18 HIV− and 44 HIV+ children. Auditory brainstem response (ABR) results were available for 72 HIV− and 72 HIV+ children. Data from ears with abnormal tympanograms were excluded. HIV+ subjects were significantly more likely to have abnormal tympanograms, histories of ear drainage, tuberculosis, or dizziness. All audiometric results were compared between groups using a two-way ANOVA with HIV status and ear drainage history as grouping variables. Mean audiometric thresholds, gap detection thresholds, and ABR latencies did not differ between groups, although the HIV+ group had a higher proportion of individuals with a hearing loss >25 dB HL in the better ear. The HIV+ group had reduced DPOAE levels (p<0.05) at multiple frequencies compared to HIV− subjects. No relationships were found between treatment regimens or delay in starting treatment and audiological parameters. As expected, children with HIV+ were more likely to have a history of ear drainage, and to have abnormal tympanograms. Similar to the adult findings, the HIV+ group did not show significantly reduced audiometric thresholds, but did have significantly lower DPOAE magnitudes. These data suggest that: (a) HIV+ children often have middle ear damage which complicates understanding the direct effects of HIV on the hearing system, and (b) even when corrected for confounders DPOAEs were lower in the HIV+ group. Previous studies suggest ototoxicity from anti-retroviral drugs is an unlikely cause of the reduced DPOAE magnitudes. Other possibilities include effects on efferent pathways connecting to outer hair cells or a direct effect of HIV on the cochlea.
