Hearing loss in children with HIV/AIDS

Buriti, Ana Karina Lima; Oliveira, Simone Helena dos Santos; Muniz, Lílian Ferreira

doi:10.1590/s2317-17822013.05000013

Cited by 11 publications

(19 citation statements)

References 22 publications

(33 reference statements)

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“…Other studies have reported a higher prevalence of hearing loss among children living with HIV than our estimates [14,17], potentially because the participants in our study were generally healthier, for instance with a low proportion of patients with WHO Stage III/IV. Furthermore, the BCOE is a tertiary health center with more resources than most health centers in Malawi, including equipment for testing hearing (e.g.…”

Section: Discussioncontrasting

confidence: 58%

“…While the World Health Organization (WHO) recommends 25dB or greater as the criteria for hearing loss [27], studies commissioned through the WHO have used 20dB as the cutoff [26], and 20dB is widely considered among audiologists as the cutoff for normal hearing. Furthermore, several studies of hearing loss in HIV-infected children have even used 15dB as the cutoff [13,16–17]. Therefore, comparison of prevalence among studies can be difficult when different cutoffs are used.…”

Section: Discussionmentioning

confidence: 99%

“…All have found a high prevalence of hearing loss in HIV-infected children, ranging between 6.4–84.8% [8–17], which is much higher when compared to general population studies in children in these countries (4% in US, 6.9% in Peru) [8,10] or to uninfected controls (8.3% in South Africa) [13]. Hearing loss in HIV can arise from a variety of causes, including recurrent otitis media, opportunistic infections such as cytomegalovirus (CMV), tuberculosis (TB) or cryptococcus, syphilis, bacterial meningitis, or from side effects of medications such as gentamicin or streptomycin [18].…”

Section: Introductionmentioning

confidence: 99%

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Hearing Loss in HIV-Infected Children in Lilongwe, Malawi

Hrapcak

Kuper

Devendra³

et al. 2016

PLoS ONE

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IntroductionWith improved access to antiretroviral therapy (ART), HIV infection is becoming a chronic illness. Preliminary data suggest that HIV-infected children have a higher risk of disabilities, including hearing impairment, although data are sparse. This study aimed to estimate the prevalence and types of hearing loss in HIV-infected children in Lilongwe, Malawi.MethodsThis was a cross-sectional survey of 380 HIV-infected children aged 4–14 years attending ART clinic in Lilongwe between December 2013-March 2014. Data was collected through pediatric quality of life and sociodemographic questionnaires, electronic medical record review, and detailed audiologic testing. Hearing loss was defined as >20 decibels hearing level (dBHL) in either ear. Predictors of hearing loss were explored by regression analysis generating age- and sex-adjusted odds ratios. Children with significant hearing loss were fitted with hearing aids.ResultsOf 380 patients, 24% had hearing loss: 82% conductive, 14% sensorineural, and 4% mixed. Twenty-one patients (23% of those with hearing loss) were referred for hearing aid fitting. There was a higher prevalence of hearing loss in children with history of frequent ear infections (OR 7.4, 4.2–13.0) and ear drainage (OR 6.4, 3.6–11.6). Hearing loss was linked to history of WHO Stage 3 (OR 2.4, 1.2–4.5) or Stage 4 (OR 6.4, 2.7–15.2) and history of malnutrition (OR 2.1, 1.3–3.5), but not to duration of ART or CD4. Only 40% of caregivers accurately perceived their child’s hearing loss. Children with hearing impairment were less likely to attend school and had poorer emotional (p = 0.02) and school functioning (p = 0.04).ConclusionsThere is an urgent need for improved screening tools, identification and treatment of hearing problems in HIV-infected children, as hearing loss was common in this group and affected school functioning and quality of life. Clear strategies were identified for prevention and treatment, since most hearing loss was conductive in nature, likely due to frequent ear infections, and many children with hearing loss qualified for hearing aids. Screening strategies need to be developed and tested since caregivers were not reliable at identifying hearing loss, and often mis-identified children with normal hearing as having hearing loss. Children with frequent ear infections, ear drainage, TB, severe HIV disease, or low BMI should receive more frequent ear assessments and hearing evaluations.

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Section: Discussioncontrasting

confidence: 58%

Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

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Hearing Loss in HIV-Infected Children in Lilongwe, Malawi

Hrapcak

Kuper

Devendra³

et al. 2016

PLoS ONE

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“…reviews or included an ineligible group of HIV participants such as people with HIV and MDRTB), were not in English ( n = 1) or the full text could not be retrieved ( n = 2) . Two further eligible studies were identified through screening references of eligible papers . Finally, 21 eligible articles were included in the review.…”

Section: Resultsmentioning

confidence: 99%

“…The characteristics of the eligible studies are summarised in Table . Eleven studies focused on children, nine on adults and one on people of all ages.…”

Section: Resultsmentioning

confidence: 99%

Is hearing impairment associated with HIV? A systematic review of data from low‐ and middle‐income countries

Ensink

Kuper

2017

Tropical Med Int Health

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The current evidence is suggestive of a high prevalence of hearing loss among people living with HIV compared to people without HIV, or to WHO estimates for the general population. More research is needed to better understand the aetiology of hearing loss in relation to HIV, and whether screening for and treatment of hearing loss can be effectively integrated into HIV treatment services needs further research.

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

et al. 2023

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ImportanceDespite normal audiometry, adults living with HIV have lower distortion product otoacoustic emissions (DPOAEs) compared with HIV-negative controls, but the degree of these differences in children living with HIV is unknown. If subclinical auditory deficits are present, results could affect developmental outcomes in children living with HIV (CLWH).ObjectiveTo compare DPOAEs and auditory brainstem responses (ABR) between 2 age- and sex-matched groups of younger children with normal audiometry, 1 infected with HIV and the other uninfected.Design, Setting, and ParticipantsCohort study in an infectious disease center in Dar es Salaam, Tanzania. Participants included 340 Tanzanian children aged 3 to 9 years with clinically normal hearing, type A tympanograms bilaterally, and air-conduction thresholds of 20 dB HL or less from 0.5 to 8 kHz. Participants in the cohort repeated testing approximately every 6 months (approximately 2.2 sessions per participant) for a total of 744 total observations. Data were analyzed from March 2020 to January 2022.Main Outcomes and MeasuresDPOAE amplitudes from 1.5 to 8 kHz using an f2 to f1 ratio of 1.2 and L1/L2 values of 65/55 dB sound pressure level and click-evoked ABR using a slow (21.1/s) and fast (61.1/s) click rate.ResultsA total of 141 CLWH (70 female participants [49.3%]; mean [SD] age, 7.24 [1.67] years) and 199 HIV-negative individuals (99 female participants [49.7%]; mean [SD] age, 7.26 [1.44] years) participated in the study. The groups did not differ significantly in age, static immittance, or air-conduction thresholds. HIV status was independently associated with approximately 1.4 dB (95% CI, −3.28 to 0.30 dB) to 3.8 dB (95% CI, 6.03 to −1.99 dB) lower DPOAE amplitudes at 6 and 8 kHz bilaterally and 0.28 μV (95% CI, 0.01 to 0.33 μV) lower ABR wave V amplitudes in the right ear.Conclusions and RelevanceConsistent with previous findings in young adults, CLWH had slightly, but reliably, lower DPOAEs and ABR wave V amplitudes than HIV-negative controls. The magnitude of these differences was small, but results suggest an early and consistent association between HIV infection or treatment and outer hair cell and auditory brainstem responses in children as young as 3 years. These subclinical changes suggest tracking both auditory function and development outcomes in CLWH is warranted.

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Hearing loss in children with HIV/AIDS

Cited by 11 publications

References 22 publications

Hearing Loss in HIV-Infected Children in Lilongwe, Malawi

Hearing Loss in HIV-Infected Children in Lilongwe, Malawi

Is hearing impairment associated with HIV? A systematic review of data from low‐ and middle‐income countries

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

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