Comparison of auditory brainstem response in HIV-1 exposed and unexposed newborns and correlation with the maternal viral load and CD4+ cell counts.

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.

DESIGN

A cohort audiometric study of newborns between October 2012 and April 2013.

SETTINGS

A secondary and tertiary hospital-based study.

PARTICIPANTS

Consecutive 126 HIV-exposed and 121 HIV-unexposed newborns.

INTERVENTION

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.

MAIN OUTCOME MEASURE

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)].

CONCLUSION

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.