MACS/WIHS Combined Cohort Study: Cook County Clinical Research Site (CC_CRS)

中老年男女听力与平衡的研究 在MACS-WIHS联合队列研究中 摘要 根据2014年美国国民健康访谈调查，18-39岁的成年人中有5.5%的人 报告在没有助听器的情况下听力有问题。在40-69岁的成年人中，这一比例为19%。 在70岁及以上的成年人中，这一比例上升到43%，其中63%的人报告有轻度听力损失。到目前为止，有 由于缺乏报道，这些艾滋病毒携带者(PLWH)的调查数据一直没有公布结果 艾滋病毒状况。在一项针对HIV阳性和HIV血清阴性的中老年男性和女性的试点研究中 在华盛顿特区和巴尔的摩进行的艾滋病毒感染与低频率和高频率有关 听力损失。但是，需要更严格的研究，特别是在美国超过一半的PLWH是 50岁以上的老年人。除了年龄和种族/民族在听力和平衡方面的差异外， 超重、饮酒增加、吸烟、体力活动减少、高血压的发生 和糖尿病是听力和平衡问题的常见危险因素。这些风险因素也可能是 PLWH较高，并具有炎症和免疫激活的共同特征。此外，听证 平衡问题可能会导致神经认知和身体功能障碍，这也是令人担忧的 在老化的PLWH中。最后，没有关于成人艾滋病毒携带者使用听力测试应用程序的研究。 评估使用听力测试应用程序的可行性和智能手机听力的准确性 需要在PLWH及其HIV血清阴性的同行中进行检测应用。我们建议解决以下问题 通过实施全群体的NHANES听证(和平衡)管理，这些知识上的差距 在MACS-WIHS联合队列研究(MWCCS)中)在大约4,100名活跃的中年人中 艾滋病毒携带者和非艾滋病毒携带者和未携带艾滋病毒的老年人。在参与者的子集中， 华盛顿-哥伦比亚特区和巴尔的摩地区2009-2010年收集的基线听力和平衡数据 在2020-2021年的跟踪检测中，我们建议调查免疫标志物的轨迹 激活和炎症有助于听力和平衡问题的进展，以及 智能手机听力测试应用可能是一种可行的方法来发现PLWH中的听力问题 与艾滋病毒血清阴性参与者相比。

Study of Hearing and Balance in Middle Aged and Aging Men and Women in the MACS- WIHS Combined Cohort Study Abstract According to the 2014 U.S. National Health Interview Survey, 5.5% of adults aged 18-39 years old self- reported trouble with hearing without a hearing aid. Among adults 40-69 years of age, the rate was 19% increasing to 43% among adults aged 70 and over with 63% reporting mild hearing loss. To date, there has been no published results from these survey data of people living with HIV (PLWH) due to lack of reported HIV status. In a pilot study of middle-aged and aging HIV positive and HIV seronegative men and women conducted in Washington DC and Baltimore, HIV infection was associated with low and high frequency hearing loss. But, more rigorous studies are needed, especially as more than half of PLWH in the U.S. are over the age of 50 years old. Besides age and race/ethnicity differences in hearing and balance, being overweight, increased alcohol consumption, smoking, less physical activity, the occurrence of hypertension and diabetes are common risk factors for hearing and balance problems. These risk factors may also be higher in PLWH and share a common hallmark of inflammation and immune activation. Furthermore, hearing and balance problems may contribute to neurocognitive and physical dysfunction, which are also of concern in aging PLWH. Finally, there is no research on the use of hearing testing applications in adults with HIV. Evaluation of the feasibility of using a hearing testing application and the accuracy of a smartphone hearing testing application in PLWH and their HIV seronegative counterparts are needed. We propose to address these gaps in knowledge by implementing cohort-wide administration of the NHANES hearing (and balance questionnaire) in the MACS-WIHS Combined Cohort Study (MWCCS) in approximately 4,100 active middle aged and aging men and women living with and without HIV. In a subset of participants from the Washington-DC and Baltimore sites with baseline hearing and balance data collected in 2009-2010 with follow-up testing in 2020-2021, we propose to investigate whether the trajectory of markers of immune activation and inflammation contribute to progression of hearing and balance issues, and whether a smartphone hearing test application may be a feasible method to capture hearing trouble in PLWH compared to HIV seronegative participants.