XVIII International AIDS Conference


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High prevalence of hearing loss and ear disease in HIV-infected Peruvian children

C.K. Chao1,2,3, A.H. Messner3, J.A. Czechowicz3, L. Kolevic4, M. Larragan5, J. Alarcon6, S. Montano7, J.R. Zunt2

1Fogarty International Research and Training Program, Bethesda, United States, 2University of Washington, Seattle, United States, 3Stanford University School of Medicine, Stanford, United States, 4Instituto Nacional de Salud del Nino, Lima, Peru, 5Hospital Nacional Arzobispo Loayza, Lima, Peru, 6Universidad Nacional Mayor de San Marcos, Lima, Peru, 7Naval Medical Research Center Detachment, Lima, Peru

Background: HIV infection has been associated with hearing loss in adults and children, but risk factors and etiologies are not well defined. The objective of this study was to determine the prevalence of and risk factors for hearing loss and other ear diseases in HIV-infected children in Peru.
Methods: Cross-sectional study of HIV-infected children ages 4 through 17 receiving care at two public hospitals in Lima, Peru: Hospital Nacional Arzobispo Loayza and Instituto Nacional de Salud del Nino. Study examination included pure-tone audiometry, tympanometry and otoscopy. Historical and socioeconomic information was obtained through parental survey and chart review. Data were analyzed using SPSS.
Results: One hundred HIV-infected Peruvian children were examined. Average age was 9.5 years; 53 (53%) were female; 86 (86%) were receiving HAART therapy (average duration 4.2 years). Hearing loss was identified through abnormal audiometry in 35 (35%) children: 30 (30%) had conductive hearing loss; 1 (1%) had sensorineural loss; and 4 (4%) had mixed conductive and sensorineural loss. Tympanic membrane (TM) pathology was seen on tympanometry in 56 (56%) children and 10 (10%) children had TM perforations. Abnormal tympanometry was correlated with history of pneumonia (p = 0.004) and three or more ear infections in the past year (p = 0.029), but not with CD4 count or HAART therapy.
Conclusions: This is the largest assessment of ear disease in HIV-infected children to date. We found a high prevalence of conductive and mixed hearing loss, abnormal tympanometry and TM perforations - significantly higher than rates reported in HIV-uninfected children in Peru and elsewhere. The mechanism of HIV-associated hearing impairment is not clearly defined, but the association with recurrent ear infections highlights the importance of screening HIV-infected children for ear infections and treating infections appropriately when detected.

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