Objectives. To measure the prevalence and to identify risk factors of hearing impairment in human immunodeficiency virus-infected children living in Peru. Study design. Cross-sectional observational study. Setting. Two public hospitals and 1 nonprofit center in Lima, Peru, between August 2009 and April 2010. Subjects. 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/mm3 (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.
Bibliographical noteFunding Information:
Funding sources: This work was supported by the following National Institutes of Health: Office of the Director; Fogarty International Center; Office of AIDS Research; National Cancer Institute; National Eye Institute; National Heart, Blood, and Lung Institute; National Institute of Dental and Craniofacial Research; National Institute on Drug Abuse; National Institutes of Mental Health; National Institute of Allergy and Infectious Diseases; and the Office of Research on Women’s Health—through the International Clinical Research Fellows Program at Vanderbilt University (R24 TW007988).
- Hearing impairment