Auditory Impairments in HIV-Infected Individuals in Tanzania

Maro, Isaac; Moshi, Ndeserua; Clavier, Odile; MacKenzie, Todd A.; Kline-Schoder, Robert; Wilbur, Jed C.; Chambers, Robert; Fellows, Abigail; Jastrzembski, Benjamin; Mascari, John E; Bakari, Muhammad; Matee, Mecky; Musiek, Frank E.; Waddell, Richard; Reyn, C. Fordham von; Buckey, Jay C.

doi:10.1097/01.aud.0000439101.07257.ed

Cited by 40 publications

(94 citation statements)

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“…In our study with 449 HIV+ adults no differences in threshold audiometry were seen between the HIV+ and HIV− groups (Maro et al 2014). Luque et al (Luque et al 2014) also showed no major differences in audiometric thresholds between HIV+ and HIV− adults in the their study of 278 HIV+ adults.…”

Section: Introductioncontrasting

confidence: 48%

“…The testing system has been described in a previous publication from our group (Maro et al 2014). The laptop-based hearing testing system included: (a) a questionnaire administered to gather data on self-reported hearing and exposure to noise, drugs and toxins, (b) tympanometry to assess middle ear function, (c) threshold audiometry (either Békésy or a modified Hughson-Westlake protocol) to measure hearing sensitivity, and (d) distortion product otoacoustic emission (DPOAE) testing to assess cochlear function.…”

Section: Methodsmentioning

confidence: 99%

“…HIV has been shown to infect the cochlea (Michaels et al 1994; Pappas et al 1994; Soucek et al 1996). The central nervous system can serve as a reservoir for HIV (Mirza et al 2012) so central auditory pathways could also be affected by HIV, which could lead to central auditory processing deficits (Maro et al 2014), or effects on efferent pathways from the brainstem and other areas to the cochlea. In addition, the presence of enhanced generalized inflammation in both untreated as well as treated HIV-infected individuals may contribute to auditory deficits if this inflammation were in the cochlea or auditory pathways.…”

Section: Introductionmentioning

confidence: 99%

“…As mentioned above, potential confounders such as noise exposure or chronic otitis need to be assessed. We are currently conducting a National Institutes of Health funded study in Tanzania to measure hearing parameters in a cohort of HIV+ and HIV− children (Maro et al 2014). The overall study includes cross-sectional results with the longitudinal study ongoing.…”

Section: Introductionmentioning

confidence: 99%

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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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Section: Introductioncontrasting

confidence: 48%

Section: Methodsmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

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Auditory Impairments in HIV-Infected Children

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“…A recent study showed that HIV infection or its treatment could be a possible cause of difficulty in perceiving sounds with relatively normal audiometry [8] . A case report in 2004 reported a patient who sustained a significant head injury and was complaining of difficulties in listening, paying attention, and communicating [9] .…”

Section: Current Proposed Classification Of Apdmentioning

confidence: 99%

Auditory Processing Disorder (APD): Progress in Diagnostics So Far. A Mini-Review on Imaging Techniques

Micallef

2016

Int Adv Otol

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Auditory processing disorder (APD) is a disorder that affects the perception of sound, both verbal and non-verbal. Patients who are generally diagnosed with APD present with abnormal hearing but have normal audiograms. There is no gold standard investigation for APD and no standardized criteria for diagnosis. Because of its disabling effect and the overlap that exists with other neurodevelopmental disorders, there is an urgent need to develop tools and criteria for appropriate diagnosis. There is a current significant focus in research on imaging techniques that can possibly be used in the future for the appropriate diagnosis of APD. Over the years, several imaging techniques have contributed significantly to defining this disorder. To date, no studies have reported the routine use of imaging for the diagnosis of APD.

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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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Auditory Impairments in HIV-Infected Individuals in Tanzania

Cited by 40 publications

References 21 publications

Auditory Impairments in HIV-Infected Children

Auditory Impairments in HIV-Infected Children

Auditory Processing Disorder (APD): Progress in Diagnostics So Far. A Mini-Review on Imaging Techniques

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

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