title: Comparison of auditory brainstem response in HIV-1 exposed and unexposed newborns and correlation with the maternal viral load and CD4+ cell counts.
abstract: OBJECTIVE
  The effects of maternal HIV infection and antiretroviral therapy on hearing of HIV-exposed newborns in sub-Saharan Africa have not been investigated. We determined the prevalence of sensorineural hearing loss among HIV-exposed newborns and the association between the hearing threshold and maternal and newborn parameters.
  
  
  METHODS
  A cohort audiometric study of newborns between October 2012 and April 2013.
  
  
  METHODS
  A secondary and tertiary hospital-based study.
  
  
  METHODS
  Consecutive 126 HIV-exposed and 121 HIV-unexposed newborns.
  
  
  METHODS
  Hearing screening of the newborns was done with Auditory Brainstem Response and compared with maternal HAART, CD4 cell counts, RNA viral loads and newborn CD4 cell count percentage.
  
  
  METHODS
  Hearing threshold levels of both groups were measured and analysed.
  
  
  RESULTS
  Around 11.1% of HIV-exposed and 6.6% of unexposed newborns had hearing impairment (P = 0.2214). About 6.4% of HIV-exposed and 2.5% HIV-unexposed newborns had hearing threshold of more than 20 dBHL (P = 0.1578). There was no significant association between the hearing thresholds of HIV-exposed newborns and maternal CD4 cell counts (P = 0.059) but there was with maternal viral load (P = 0.034). There was significant difference between the hearing thresholds of HIV-exposed newborns with CD4% of 25 or less and more than 25. This study showed significant difference in the hearing of the 119 HAART-exposed newborns and seven unexposed newborns [P = 0.002; risk ratio, 0.13 (0.05-0.32)].
  
  
  CONCLUSIONS
  There was a trend towards more hearing loss in HIV-exposed newborns. However, hearing thresholds increase with increasing mothers' viral load. The background information supports the need for further studies on the role of in-utero exposure to HIV and HAART in newborn hearing loss.
authors.affiliation: aDepartment of Otorhinolaryngology bDepartment of Virology cDepartment of Obstetrics and Gynaecology dDepartment of Paediatrics, College of Medicine, University of Ibadan, Ibadan, Nigeria eMedical Education Partnership in Nigeria, Ibadan fPresident's Emergency Plan For AIDS Relief - AIDS Prevention Initiative Nigeria (PEPFAR-APIN PLUS), Ibadan, Nigeria gCenter for Global Health, Feinberg School of Medicine, Northwestern University, Chicago, Illinois, USA.
authors.forename: Ayotunde James
authors.initials: AJ
authors.lastname: Fasunla
authors.forename: Babatunde Oluwatosin
authors.initials: BO
authors.lastname: Ogunbosi
authors.forename: Georgina Njideka
authors.initials: GN
authors.lastname: Odaibo
authors.forename: Onyekwere George Benjamin
authors.initials: OG
authors.lastname: Nwaorgu
authors.forename: Babafemi
authors.initials: B
authors.lastname: Taiwo
authors.forename: David Olufemi
authors.initials: DO
authors.lastname: Olaleye
authors.forename: Kikelomo
authors.initials: K
authors.lastname: Osinusi
authors.forename: Robert Leo
authors.initials: RL
authors.lastname: Murphy
authors.forename: Isaac Folorunso
authors.initials: IF
authors.lastname: Adewole
authors.forename: Olusegun Olusina
authors.initials: OO
authors.lastname: Akinyinka
mesh_terms: D017954:Africa South of the Sahara; D001299:Audiometry; D018791:CD4 Lymphocyte Count; D015331:Cohort Studies; D016057:Evoked Potentials, Auditory, Brain Stem; D005260:Female; D015658:HIV Infections / Q000821:virology*; D034381:Hearing Loss / Q000175:diagnosis / Q000453:epidemiology*; D006801:Humans; D007231:Infant, Newborn; D008297:Male; D008431:Maternal-Fetal Exchange; D011247:Pregnancy; D019562:Viral Load