title: Hearing loss in perinatally HIV-infected and HIV-exposed but uninfected children and adolescents.
abstract: 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 with the percentage with hearing loss in the general population and evaluated possible risk factors for hearing loss in HIV+ and HEU children.
  
  
  METHODS
  Audiometric examinations were completed in children who met any prespecified 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. The associations of demographic variables, 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 = 2.13, 95% confidence interval: 0.95-4.76, P = 0.07). Among HIV+ children, those with a Centers for Disease Control and Prevention class C diagnosis had over twice the odds of hearing loss (adjusted odds ratio = 2.47, 95% confidence interval: 1.04-5.87, P = 0.04). The prevalence of hearing loss was higher in both HIV+ and HEU children compared with National Health and Nutrition Examination Survey III children.
  
  
  CONCLUSIONS
  Hearing loss was more common in both HIV+ and HEU children than in children from a US population sample. More advanced HIV illness increased the risk of hearing loss in HIV+ children.
authors.affiliation: School of Speech, Language, and Hearing Sciences, San Diego State University, San Diego, CA 92182-1518, USA. ptorre@mail.sdsu.edu
authors.forename: Peter
authors.initials: P
authors.lastname: Torre
authors.forename: Bret
authors.initials: B
authors.lastname: Zeldow
authors.forename: Howard J
authors.initials: HJ
authors.lastname: Hoffman
authors.forename: Ashley
authors.initials: A
authors.lastname: Buchanan
authors.forename: George K
authors.initials: GK
authors.lastname: Siberry
authors.forename: Mabel
authors.initials: M
authors.lastname: Rice
authors.forename: Patricia A
authors.initials: PA
authors.lastname: Sirois
authors.forename: Paige L
authors.initials: PL
authors.lastname: Williams
mesh_terms: D000293:Adolescent; D000704:Analysis of Variance; D044966:Anti-Retroviral Agents / Q000627:therapeutic use; D001299:Audiometry; D002648:Child; D003430:Cross-Sectional Studies; D005260:Female; D015658:HIV Infections / Q000150:complications* / Q000188:drug therapy / Q000453:epidemiology*; D034381:Hearing Loss / Q000150:complications / Q000453:epidemiology* / Q000821:virology*; D006801:Humans; D016015:Logistic Models; D008297:Male; D015995:Prevalence; D011647:Puerto Rico / Q000453:epidemiology; D012307:Risk Factors; D014481:United States / Q000453:epidemiology
chemical_list: D044966:Anti-Retroviral Agents