Human Immunodeficiency Virus and the Central Nervous System

Mirza, Ayesha; Rathore, Mobeen H.

doi:10.1016/j.spen.2012.02.007

Cited by 23 publications

(7 citation statements)

References 82 publications

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“…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%

“…Even in the treated state, substantial concern exists for continued central nervous system (CNS) involvement given its compartmental nature and differential pharmacokinetic distribution of antiretroviral drugs. Neurocognitive deficits are still seen in HIV+ individuals despite active antiretroviral therapy (ART) (Mirza and Rathore 2012). Taken together, existing data suggest multiple potential ways that HIV could affect the hearing system.…”

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: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Auditory Impairments in HIV-Infected Children

et al. 2016

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“…Even in the treated state, substantial concern exists for continued CNS involvement given its compartmental nature and differential pharmacokinetic distribution of antiretrovirals (ARVs). Neurocognitive deficits are still seen in HIV+ individuals despite active antiretroviral therapy (Mirza and Rathore 2012). Taken together, existing data suggest multiple potential ways that HIV could affect hearing, but to date, no large scale study has shown which of these potential causes predominates or how frequently hearing problems occur in HIV+ individuals.…”

Section: Introductionmentioning

confidence: 99%

Auditory Impairments in HIV-Infected Individuals in Tanzania

et al. 2014

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Objectives Abnormal hearing tests have been noted in HIV-infected patients in several studies, but the nature of the hearing deficit has not been clearly defined. We performed a cross-sectional study of both HIV+ and HIV− individuals in Tanzania using an audiological test battery. We hypothesized that HIV+ adults would have a higher prevalence of abnormal central and peripheral hearing test results compared to HIV− controls. Additionally, we anticipated that the prevalence of abnormal hearing assessments would increase with anti-retroviral therapy (ART) use, and treatment for tuberculosis (TB). Design Pure-tone thresholds, distortion product otoacoustic emissions (DPOAEs), tympanometry, and a gap detection test were performed using a laptop-based hearing testing system on 751 subjects (100 HIV− in the U.S., plus 651 in Dar es Salaam Tanzania including 449 HIV+ [130 ART− and 319 ART+], and 202 HIV−, subjects. No U.S. subjects had a history of TB treatment. In Tanzania, 204 of the HIV+, and 23 of the HIV−, subjects had a history of TB treatment. Subjects completed a video and audio questionnaire about their hearing as well as a health history questionnaire. Results HIV+ subjects had reduced DPOAE levels compared to HIV− subjects, but their hearing thresholds, tympanometry results, and gap detection thresholds were similar. Within the HIV+ group, those on ART reported significantly greater difficulties understanding speech-in-noise, and were significantly more likely to report that they had difficulty understanding speech than the ART− group. The ART+ group had a significantly higher mean gap detection threshold compared to the ART− group. No effects of TB treatment were seen. Conclusions The fact that the ART+/ART− groups did not differ in measures of peripheral hearing ability (DPOAEs, thresholds), or middle ear measures (tympanometry), but that the ART+ group had significantly more trouble understanding speech and higher gap detection thresholds, indicates a central processing deficit. These data suggest that: (a) hearing deficits in HIV+ individuals could be a central nervous system (CNS) side effect of HIV infection, (b) certain ART regimens might produce CNS side effects that manifest themselves as hearing difficulties, and/or (c) some ART regimens may treat CNS HIV inadequately, perhaps due to insufficient CNS drug levels, which is reflected as a central hearing deficit. Monitoring of central hearing parameters could be used to track central effects of either HIV or ART.

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“…Macrophages and dendritic cells are also targets of HIV infection. [42][43] The HIV/AIDS is a challenge for healthcare providers due to lack of resources, limited infrastructure and low socioeconomic status and educational level of most patients. [44][45] Thus, we emphasize the importance of promoting health, which is understood as a process of empowerment of individuals and the community to work on improving the quality of life and health.…”

Section: Discussionmentioning

confidence: 99%

Efeito do suporte social na vida de adultos com HIV/AIDS Effect of social support in the lives of adults with HIV/AIDS

Galvão

2016

R. pesq. cuid. fundam. online

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Objetivo: Analisar o efeito do suporte social na vida de pacientes adultos com Vírus da Imunodeficiência Humana (HIV)/Síndrome da Imunodeficiência Adquirida (aids). Método: A revisão integrativa da literatura foi realizada em seis bases de dados, entre os meses de agosto a outubro de 2014. Utilizaram-se os descritores aids e suporte social, nos idiomas português, inglês ou espanhol e o operador booleano and. Foram encontrados 1.561 artigos e selecionados 33. Resultados: Identificou-se que o suporte social tem efeito positivo sobre a saúde mental, aderência à terapia antirretroviral, estado de saúde, qualidade de vida e manutenção do sexo seguro. Conclusão: Considera-se que o estabelecimento de relações mais profundas entre o suporte social e outros aspectos da vida das pessoas com HIV/aids, possam ser utilizados para a promoção da saúde desses indivíduos, com o intuito de diminuir a morbidade e aumentar a sobrevida desses pacientes. Descritores: HIV, Síndrome de Imunodeficiência Adquirida, Apoio Social.

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Human Immunodeficiency Virus and the Central Nervous System

Cited by 23 publications

References 82 publications

Auditory Impairments in HIV-Infected Children

Auditory Impairments in HIV-Infected Children

Auditory Impairments in HIV-Infected Individuals in Tanzania

Efeito do suporte social na vida de adultos com HIV/AIDS Effect of social support in the lives of adults with HIV/AIDS

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