Hearing Loss in Perinatally Human Immunodeficiency Virus-Infected and Human Immunodeficiency Virus-Exposed but Uninfected Children and Adolescents

Background—Little is known about hearing loss in children with HIV infection (HIV+). We examined the prevalence of hearing loss in perinatally HIV+ and HIV-exposed but uninfected (HEU) children, compared these to the percentage with hearing loss in the general population, and evaluated possible risk factors for hearing loss in HIV+ and HEU children. Corresponding author: Peter Torre III, PhD, School of Speech, Language, and Hearing Sciences, San Diego State University, 5500 Campanile Dr., SLHS 244, San Diego, CA 92182-1518, ptorre@mail.sdsu.edu, (619) 594-4787, FAX: (619) 594-7109. Publisher's Disclaimer: This is a PDF file of an unedited manuscript that has been accepted for publication. As a service to our customers we are providing this early version of the manuscript. The manuscript will undergo copyediting, typesetting, and review of the resulting proof before it is published in its final citable form. Please note that during the production process errors may be discovered which could affect the content, and all legal disclaimers that apply to the journal pertain. The following institutions, clinical site investigators and staff participated in conducting PHACS AMP in 2010, in alphabetical order: Baylor College of Medicine: William Shearer, Mary Paul, Norma Cooper, Lynette Harris; Bronx Lebanon Hospital Center: Murli Purswani, Mahboobullah Baig, Anna Cintron; Children's Diagnostic & Treatment Center: Ana Puga, Sandra Navarro, Doyle Patton, Deyana Leon; Children’s Hospital, Boston: Sandra Burchett, Nancy Karthas, Betsy Kammerer; Children’s Memorial Hospital: Ram Yogev, Margaret Ann Sanders, Kathleen Malee, Scott Hunter; Jacobi Medical Center: Andrew Wiznia, Marlene Burey, Molly Nozyce; St. Christopher’s Hospital for Children: Janet Chen, Latreca Ivey, Maria Garcia Bulkley, Mitzie Grant; St. Jude Children's Research Hospital: Katherine Knapp, Kim Allison, Megan Wilkins; San Juan Hospital/Department of Pediatrics: Midnela Acevedo-Flores, Heida Rios, Vivian Olivera; Tulane University Health Sciences Center: Margarita Silio, Medea Jones, Patricia Sirois; University of California, San Diego: Stephen Spector, Kim Norris, Sharon Nichols; University of Colorado Denver Health Sciences Center: Elizabeth McFarland, Emily Barr, Robin McEvoy; University of Maryland, Baltimore: Douglas Watson, Nicole Messenger, Rose Belanger; University of Medicine and Dentistry of New Jersey: Arry Dieudonne, Linda Bettica, Susan Adubato; University of Miami: Gwendolyn Scott, Patricia Bryan, Elizabeth Willen. Note: The conclusions and opinions expressed in this article are those of the authors and do not necessarily reflect those of the National Institutes of Health or U.S. Department of Health and Human Services. Disclosures: The authors have no conflicts of interest or funding to disclose. NIH Public Access Author Manuscript Pediatr Infect Dis J. Author manuscript; available in PMC 2013 August 01. Published in final edited form as: Pediatr Infect Dis J. 2012 August ; 31(8): 835–841. doi:10.1097/INF.0b013e31825b9524. N IH PA Athor M anscript N IH PA Athor M anscript N IH PA Athor M anscript Methods—Audiometric examinations were completed in children who met any pre-specified criteria for possible hearing loss. The hearing examination consisted of a tympanogram in each ear and pure-tone air-conduction threshold testing from 500 through 4000 Hz. Hearing loss was defined as the pure-tone average over these frequencies ≥20 dB hearing level (HL). The associations of demographic, parent/caregiver, HIV disease, and HIV treatment with hearing loss were evaluated with univariate and multivariable logistic regression models. Results—Hearing testing was completed in 231 children (145 HIV+ and 86 HEU). Hearing loss occurred in 20.0% of HIV+ children and 10.5% of HEU children. After adjusting for caregiver education level, HIV infection was associated with increased odds of hearing loss [adjusted odds ratio (aOR)=2.13, 95% confidence interval (CI): 0.95–4.76, p=0.07]. Among HIV+ children, those with a CDC Class C diagnosis had over twice the odds of hearing loss (aOR=2.47, 95% CI: 1.04– 5.87, p=0.04). The prevalence of hearing loss was higher in both HIV+ and HEU children compared with NHANES III children. Conclusions—Hearing loss was more common in both HIV+ and HEU children than in healthy children. More advanced HIV illness increased the risk of hearing loss in HIV+ children.