Auditory impairments in hiv-infected individuals in tanzania

Isaac I. Maro, Ndeserua Moshi, Odile H. Clavier, Todd A. Mackenzie, Robert J. Kline-Schoder, Jed C. Wilbur, Robert D. Chambers, Abigail M. Fellows, Benjamin G. Jastrzembski, John E. Mascari, Muhammad Bakari, Mecky Matee, Frank Musiek, Richard D. Waddell, C. Fordham Von Reyn, Jay C. Buckey

Research output: Contribution to journalArticle

13 Citations (Scopus)

Abstract

OBJECTIVES:: Abnormal hearing tests have been noted in human immunodeficiency virus (HIV)-infected patients in several studies, but the nature of the hearing deficit has not been clearly defined. The authors performed a cross-sectional study of both HIV+ and HIV- individuals in Tanzania by using an audiological test battery. The authors hypothesized that HIV+ adults would have a higher prevalence of abnormal central and peripheral hearing test results compared with HIV- controls. In addition, they anticipated that the prevalence of abnormal hearing assessments would increase with antiretroviral 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 United States, 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 with 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 with 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 had higher gap-detection thresholds indicates a central processing deficit. These data suggest that: (1) hearing deficits in HIV+ individuals could be a CNS side effect of HIV infection, (2) certain ART regimens might produce CNS side effects that manifest themselves as hearing difficulties, and/or (3) 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.

Original languageEnglish (US)
Pages (from-to)306-317
Number of pages12
JournalEar and Hearing
Volume35
Issue number3
DOIs
StatePublished - 2014
Externally publishedYes

Fingerprint

Tanzania
HIV
Hearing
Group Psychotherapy
Acoustic Impedance Tests
Tuberculosis
Therapeutics
Hearing Tests
Speech Therapy
HIV-2
Aptitude
Middle Ear
Virus Diseases

Keywords

  • Audiometry
  • Central auditory processing
  • Distortion produ ctotoacoustic emissions
  • Gap-detection testing
  • Human immunodeficiency virus

ASJC Scopus subject areas

  • Otorhinolaryngology
  • Speech and Hearing
  • Medicine(all)

Cite this

Maro, I. I., Moshi, N., Clavier, O. H., Mackenzie, T. A., Kline-Schoder, R. J., Wilbur, J. C., ... Buckey, J. C. (2014). Auditory impairments in hiv-infected individuals in tanzania. Ear and Hearing, 35(3), 306-317. https://doi.org/10.1097/01.aud.0000439101.07257.ed

Auditory impairments in hiv-infected individuals in tanzania. / Maro, Isaac I.; Moshi, Ndeserua; Clavier, Odile H.; Mackenzie, Todd A.; Kline-Schoder, Robert J.; Wilbur, Jed C.; Chambers, Robert D.; Fellows, Abigail M.; Jastrzembski, Benjamin G.; Mascari, John E.; Bakari, Muhammad; Matee, Mecky; Musiek, Frank; Waddell, Richard D.; Von Reyn, C. Fordham; Buckey, Jay C.

In: Ear and Hearing, Vol. 35, No. 3, 2014, p. 306-317.

Research output: Contribution to journalArticle

Maro, II, Moshi, N, Clavier, OH, Mackenzie, TA, Kline-Schoder, RJ, Wilbur, JC, Chambers, RD, Fellows, AM, Jastrzembski, BG, Mascari, JE, Bakari, M, Matee, M, Musiek, F, Waddell, RD, Von Reyn, CF & Buckey, JC 2014, 'Auditory impairments in hiv-infected individuals in tanzania', Ear and Hearing, vol. 35, no. 3, pp. 306-317. https://doi.org/10.1097/01.aud.0000439101.07257.ed
Maro II, Moshi N, Clavier OH, Mackenzie TA, Kline-Schoder RJ, Wilbur JC et al. Auditory impairments in hiv-infected individuals in tanzania. Ear and Hearing. 2014;35(3):306-317. https://doi.org/10.1097/01.aud.0000439101.07257.ed
Maro, Isaac I. ; Moshi, Ndeserua ; Clavier, Odile H. ; Mackenzie, Todd A. ; Kline-Schoder, Robert J. ; Wilbur, Jed C. ; Chambers, Robert D. ; Fellows, Abigail M. ; Jastrzembski, Benjamin G. ; Mascari, John E. ; Bakari, Muhammad ; Matee, Mecky ; Musiek, Frank ; Waddell, Richard D. ; Von Reyn, C. Fordham ; Buckey, Jay C. / Auditory impairments in hiv-infected individuals in tanzania. In: Ear and Hearing. 2014 ; Vol. 35, No. 3. pp. 306-317.
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T1 - Auditory impairments in hiv-infected individuals in tanzania

AU - Maro, Isaac I.

AU - Moshi, Ndeserua

AU - Clavier, Odile H.

AU - Mackenzie, Todd A.

AU - Kline-Schoder, Robert J.

AU - Wilbur, Jed C.

AU - Chambers, Robert D.

AU - Fellows, Abigail M.

AU - Jastrzembski, Benjamin G.

AU - Mascari, John E.

AU - Bakari, Muhammad

AU - Matee, Mecky

AU - Musiek, Frank

AU - Waddell, Richard D.

AU - Von Reyn, C. Fordham

AU - Buckey, Jay C.

PY - 2014

Y1 - 2014

N2 - OBJECTIVES:: Abnormal hearing tests have been noted in human immunodeficiency virus (HIV)-infected patients in several studies, but the nature of the hearing deficit has not been clearly defined. The authors performed a cross-sectional study of both HIV+ and HIV- individuals in Tanzania by using an audiological test battery. The authors hypothesized that HIV+ adults would have a higher prevalence of abnormal central and peripheral hearing test results compared with HIV- controls. In addition, they anticipated that the prevalence of abnormal hearing assessments would increase with antiretroviral 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 United States, 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 with 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 with 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 had higher gap-detection thresholds indicates a central processing deficit. These data suggest that: (1) hearing deficits in HIV+ individuals could be a CNS side effect of HIV infection, (2) certain ART regimens might produce CNS side effects that manifest themselves as hearing difficulties, and/or (3) 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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KW - Central auditory processing

KW - Distortion produ ctotoacoustic emissions

KW - Gap-detection testing

KW - Human immunodeficiency virus

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