Effect of HIV Infection and Highly Active Antiretroviral Therapy on Hearing Function: A Prospective Case-Control Study From Cameroon.
OBJECTIVE
Human immunodeficiency virus (HIV) infection remains a major cause of morbidity and mortality worldwide. Many studies have found a higher prevalence of hearing impairment among HIV-positive individuals.


OBJECTIVE
To investigate the effect of HIV and highly active antiretroviral treatment (HAART) on the hearing function in a Cameroonian population.


METHODS
We conducted a prospective case-control study from March 1, 2012, through January 31, 2013. The study took place at the National Social Insurance Fund Hospital in Yaoundé, Cameroon, a public health facility. We included 90 HIV-positive case patients and 90 HIV-negative control patients aged 15 to 49 years without any history of hearing loss or treatment with a known ototoxic drug. The case group was further divided into 3 subgroups: 30 HAART-naive patients, 30 patients receiving first-line HAART, and 30 patients receiving second-line HAART.


METHODS
Hearing function was assessed by pure-tone audiometry and classified according to the criteria of the Bureau International d'Audio-Phonologie.


METHODS
Hearing loss due to HIV and HAART.


RESULTS
The HIV-positive patients had more otologic symptoms (hearing loss, dizziness, tinnitus, and otalgia) than HIV-negative patients (41 vs 13, P = .04). There were 49 cases (27.2%) of hearing loss in the HIV-positive group vs 10 (5.6%) in the HIV-negative group (P = .04). Compared with HIV-negative individuals, the odds of hearing loss were higher among HIV-infected HAART-naive patients (right ear: odds ratio [OR], 6.7; 95% CI, 4.3-9.7; P = .004; left ear: OR, 6.2; 95% CI, 3.5-8.3; P = .006), patients receiving first-line HAART (right ear: OR, 5.6; 95% CI, 1.9-10.5; P = .01; left ear: OR, 12.5; 95% CI, 8.5-15.4; P < .001), and patients receiving second-line HAART (right ear: OR, 6.7; 95% CI, 3.3-9.6; P = .004; left ear: OR, 3.7; 95% CI, 3.0-5.0; P = .08).


CONCLUSIONS
Hearing loss is more frequent in HIV-infected patients compared with uninfected patients. Therefore, HIV-infected patients need special audiologic care. Further studies are needed because controversy remains regarding the factors that lead to ear damage.
Department of Medicine and Biomedical Sciences, University of Yaoundé I, Yaoundé, Cameroon.
Jean Valentin F
JV
Fokouo
Department of Medicine and Biomedical Sciences, University of Yaoundé I, Yaoundé, Cameroon2National Social Insurance Fund Hospital, Yaoundé, Cameroon.
Jean Espoir E
JE
Vokwely
Edéa Regional Hospital, Edéa, Cameroon4Medical Diagnostic Center, Yaoundé, Cameroon.
Jean Jacques N
JJ
Noubiap
Department of Internal Medicine, University of British Columbia, Vancouver, British Columbia, Canada.
Brice Enid
BE
Nouthe
Department of Preventive and Social Medicine, Laval University, Québec City, Québec, Canada.
Joseline
J
Zafack
Douala General Hospital, Douala, Cameroon.
Esthelle Stéphanie
ES
Minka Ngom
Yaoundé General Hospital, Yaoundé, Cameroon.
Asmaou Bouba
AB
Dalil
Geneva Teaching Hospital, Geneva, Switzerland.
Adèle-Rose
AR
Ngo Nyeki
Department of Medicine and Biomedical Sciences, University of Yaoundé I, Yaoundé, Cameroon.
Géneviève
G
Bengono
Department of Medicine and Biomedical Sciences, University of Yaoundé I, Yaoundé, Cameroon3Edéa Regional Hospital, Edéa, Cameroon7Douala General Hospital, Douala, Cameroon.
Richard
R
Njock
D000293:Adolescent; D000328:Adult; D023241:Antiretroviral Therapy, Highly Active / Q000009:adverse effects*; D001301:Audiometry, Pure-Tone; D002163:Cameroon / Q000453:epidemiology; D016022:Case-Control Studies; D004244:Dizziness / Q000453:epidemiology*; D004433:Earache / Q000453:epidemiology*; D005260:Female; D015658:HIV Infections / Q000150:complications* / Q000188:drug therapy* / Q000453:epidemiology; D034381:Hearing Loss / Q000453:epidemiology*; D006801:Humans; D008297:Male; D008875:Middle Aged; D011446:Prospective Studies; D014012:Tinnitus / Q000453:epidemiology*