title: High prevalence of hearing impairment in HIV-infected Peruvian children.
abstract: OBJECTIVE
  To measure the prevalence and to identify risk factors of hearing impairment in human immunodeficiency virus-infected children living in Peru.
  
  
  METHODS
  Cross-sectional observational study.
  
  
  METHODS
  Two public hospitals and 1 nonprofit center in Lima, Peru, between August 2009 and April 2010.
  
  
  METHODS
  A total of 139 HIV-infected children, ages 4 to 19 years.
  
  
  METHODS
  Hearing impairment and otologic health were assessed with pure tone audiometry, tympanometry, and otoscopy. The primary outcome was hearing loss, defined as average threshold >25dB for 0.5, 1, 2, and 4 kHz, in one or both ears. Historical and socioeconomic information was obtained through parental survey and medical chart review. Statistical analysis included univariate analysis and multivariate logistic regression.
  
  
  RESULTS
  Fifty-four (38.8%) of 139 children had hearing impairment. On multivariate analysis, risk factors included: tympanic membrane perforation (odds ratio [OR] 7.08; 95% confidence interval [CI], 1.65-30.5; P = .01), abnormal tympanometry (OR 2.71; 95% CI, 1.09-6.75; P = .03), cerebral infection (OR 11.6; 95% CI, 1.06-126; P = .05), seizures (OR 5.20; 95% CI, 1.21-22.4; P = .03), and CD4 cell count <500 cells/mm(3) (OR 3.53; 95% CI, 1.18-10.5; P = .02).
  
  
  CONCLUSIONS
  The prevalence of hearing impairment in HIV-infected children in Lima, Peru was 38.8%. Middle ear disease, prior cerebral infection, and low CD4 cell count were significantly associated with hearing impairment. The high prevalence of hearing impairment emphasizes the need for periodic hearing assessment in the routine clinical care of HIV-infected children.
authors: Department of Otolaryngology-Head and Neck Surgery, Stanford University School of Medicine, Stanford, California, USA.
authors: Christina K
authors: CK
authors: Chao
authors: Josephine A
authors: JA
authors: Czechowicz
authors: Anna H
authors: AH
authors: Messner
authors: Jorge
authors: J
authors: Alarcón
authors: Lenka
authors: L
authors: Kolevic Roca
authors: Marsi M
authors: MM
authors: Larragán Rodriguez
authors: César
authors: C
authors: Gutiérrez Villafuerte
authors: Silvia M
authors: SM
authors: Montano
authors: Joseph R
authors: JR
authors: Zunt
mesh_terms: D002648:Child; D002675:Child, Preschool; D003430:Cross-Sectional Studies; D005260:Female; D015658:HIV Infections / Q000150:complications*; D034381:Hearing Loss / Q000150:complications* / Q000453:epidemiology*; D006801:Humans; D008297:Male; D010568:Peru / Q000453:epidemiology; D015995:Prevalence; D012307:Risk Factors