Peripheral Auditory Function in Young HIV‐Positive Adults With Clinically Normal Hearing

Abstract

Objective Little is known about peripheral auditory function in young adults with HIV, who might be expected to show early evidence of hearing loss if HIV infection or treatment does affect peripheral function. The goal of this study was to compare peripheral auditory function in 2 age- and gender-matched groups of young adults with clinically normal hearing with and without HIV. Study Design Matched cohort study with repeated measures. Setting Infectious disease center in Dar es Salaam, Tanzania. Methods Participants included HIV-positive (n = 38) and HIV-negative (n = 38) adults aged 20 to 30 years who had clinically normal hearing, defined as type A tympanograms, air conduction thresholds ≤25 dB HL bilaterally from 0.5 to 8 kHz, and distortion product otoacoustic emissions (DPOAEs) >6 dB above the noise floor bilaterally from 1.5 to 8 kHz. Participants were tested multiple times over 6-month intervals (average, 2.7 sessions/participant) for a total of 208 observations. Primary outcome measures included tympanograms, air conduction audiograms, DPOAEs, and click-evoked auditory brainstem responses. Results HIV groups did not significantly differ in age, static immittance, or air conduction thresholds. HIV-positive status was independently associated with approximately 3.7-dB lower DPOAE amplitudes from 2 to 8 kHz (95% CI, 1.01-6.82) in both ears and 0.04-µV lower (95% CI, 0.003-0.076) auditory brainstem response wave I amplitudes in the right ear. Conclusion Young adults living with HIV have slightly but reliably smaller DPOAEs and auditory brainstem response wave I amplitudes than matched HIV-negative controls. The magnitude of these differences is small, but these results support measuring peripheral auditory function in HIV-positive individuals as they age.

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

“…These results are consistent with our previous work in young adults, aged 20 to 30 years, 12 middle age adults, aged 37 to 49 years, 4 and HIV-positive children aged 1 to 18 years 15 living in Dar es Salaam, Tanzania. All previous studies found slightly, but reliably, smaller DPOAEs in HIV-positive individuals compared with HIV-negative individuals.…”

“…We hypothesized subclinical decreases in peripheral auditory function in the CLWH due to HIV infection or treatment effects on auditory function according to our previous work in a young adult cohort. 12 Results from the current study are consistent with subtle but significant reductions in high frequency DPOAEs and ABR wave V amplitude in CLWH compared with an ageand sex-matched HIV-negative group. HIV-positive status was independently associated with approximately 0.4 to 3.8 dB lower DPOAE amplitudes at 6 and 8 kHz in both ears and approximately 0.28μV lower ABR wave V amplitudes in the right ear.…”

“…This selection resulted in children with a mean (SD) of 2.18 (0.98) observations (ie, visits) per child (Table 1). Peripheral auditory assessment protocols have been previously described in Niemczak et al 12 and summarized below.…”

“…DPOAEs were collected with Creare LLC's system at f2 values of 1.5, 2, 3, 4, 6, and 8 kHz using an f2 to f1 ratio of 1.2 and L1/L2 values of 65/55 dB sound pressure level as in our previous work. 2,12 The f2 to f1 frequency pair was delivered for a minimum of 4s. After 4s, if the DPOAE level and averaged noise floor level difference was less than 10 dB signal-to-noise ratio, the frequency pair continued until either a DPOAE signal-to-noise ratio of 10 was reached or 10s had elapsed.…”

“…The current study expands previous work with young adults by comparing peripheral auditory function between young CLWH and age-and sex matched HIV-negative controls who all have clinically normal hearing. 12 The data come from a longitudinal cohort of children in Tanzania who have been studied over the course of 3 years to assess if central auditory function is associated with literacy outcomes. This cohort has been tested with a comprehensive battery of both peripheral and central auditory tests and provides a unique opportunity to assess auditory function in CLWH in a low-to-middle-income country.…”