Otolaryngological, head and neck manifestations in HIV-infected patients seen at Steve Biko Academic Hospital in Pretoria, South Africa

Objectives: To gather and analyse information concerning the aetiology and pathology of otitis media with effusion in adults.Method: A review of the English language literature from 1970 to the present was conducted.Results: The available evidence suggests that otitis media with effusion in adult life is best viewed as a syndrome with a number of causes, including: infiltration of the eustachian tube by nasopharyngeal carcinoma and other local malignancies; changes in the middle ear and eustachian tube induced by radiotherapy; and systemic disease.Conclusion: There is now a body of evidence specifically related to the aetiology and pathology of otitis media with effusion in adult life. However, further research is required to fill in the gaps in our knowledge and understanding of this condition.

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“…28,30 Human immunodeficiency virus Otitis media with effusion has been reported in association with human immunodeficiency virus infection. 31 …”

Section: Smokingmentioning

confidence: 99%

Aetiology and pathology of otitis media with effusion in adult life

Mills

Hathorn

2016

J. Laryngol. Otol.

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“…Furthermore, the age-specific prevalence of hearing impairment may also increase for a variety of reasons. In the coming decade, HIV and tuberculosis will become more chronic conditions, thanks to the scaling up of antiretroviral therapy (ART) and other treatments, and so the burden of chronic suppurative otitis media (CSOM) and associated hearing loss will likely increase dramatically [2,3]. It is also predicted that 70% of cancers will occur in developing countries by the year 2030, including those relating to ear, nose, and throat (ENT) [4].…”

Section: Introductionmentioning

confidence: 99%

Survey of ENT services in sub-Saharan Africa: little progress between 2009 and 2015

Mulwafu

Ensink

Kuper

et al. 2017

Global Health Action

144

158

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Background: A 2009 survey of ENT, audiology, and speech therapy services and training opportunities in 18 Sub-Saharan African countries reported that the availability of services was extremely poor, the distribution of services was very inequitable, and training opportunities were limited.Objective: We conducted a new survey to determine the current status of ear, nose, and throat (ENT), audiology, and speech therapy services in sub-Saharan Africa.Method: This study is a cross-sectional study. A questionnaire was distributed by email to an ad hoc group of ENT surgeons and audiologists in 30 sub-Saharan African countries. Data from the current survey were compared to those of a 2009 survey. The numbers of ENT surgeons, audiologists, and speech therapists/100,000 people were compared to the ratios in the United Kingdom.Results: A total of 22 countries responded to the questionnaire. When data of the 15 countries that responded in both 2009 and 2015 are compared, the number of ENT surgeons had increased by 43%, audiologists had increased by 2.5%, and speech therapists by 30%. When the 23% population growth is taken into account, the numbers of ENT surgeons, audiologists, and speech therapists per 100,000 people had declined in four countries, and there remains a severe shortfall of ENT surgeons, audiologists, and speech therapists when compared to the UK Respondents cited lack of availability of basic equipment as the most frequent limitation in providing ENT services. Other important factors causing limitations in daily practice were: lack of ENT training facilities and audiological rehabilitation, low awareness of the burden of ENT pathology, as well as poor human resources management.Conclusions: There has been a lack of progress in ENT, audiology, and speech therapy services and training opportunities in sub-Saharan Africa between 2009 and 2015. There is a need to look at increased collaboration with developed countries and non-governmental organisations, establishing new and improving existing training centres in Africa, and task-shifting of some ENT services to primary health workers.

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“…HIV treatment also involves many medications, some of which may be ototoxic, or could increase the sensitivity to other insults such as noise (Bektas et al 2008). Children with HIV are more susceptible to ear infections, which could lead to middle ear problems, and potentially, cochlear damage (Hallbauer et al 2014; Jose et al 2013; Taipale et al 2011; Tshifularo et al 2013). …”

Section: Introductionmentioning

confidence: 99%

Auditory Impairments in HIV-Infected Children

et al. 2016

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Objectives 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. Design 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. Results 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. Conclusions 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.

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Otolaryngological, head and neck manifestations in HIV-infected patients seen at Steve Biko Academic Hospital in Pretoria, South Africa

Cited by 43 publications

References 8 publications

Aetiology and pathology of otitis media with effusion in adult life

Aetiology and pathology of otitis media with effusion in adult life

Survey of ENT services in sub-Saharan Africa: little progress between 2009 and 2015

Auditory Impairments in HIV-Infected Children

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