Chidziva C, Matsekete J, Bandason T, Shamu S, Dzongodza T, Matinhira N, Mujuru H A, Kunzekwenyika C, Wellington M, Luthy R, Prescott C, Ferrand R A
Cent Afr J Med. 2015 Sep-Dec;61(9-12):56-61.
Among HIV-infected children ear infections are recurrent and chronic, which may lead to hearing loss.
To determine the prevalence, cause and severity of hearing impairment among HIV-infected children aged 5-17 years attending for HIV care in Harare.
An analytical cross-sectional survey conducted at Newlands Clinic, an opportunistic infections clinic in Harare.
Participants underwent a standardised otoscopic examination of the ear and Pure Tone Audiometry (PTA). Factors associated with hearing impairment were investigated using multivariate logistic regression.
Three hundred and eighty (380) participants (55% female and mean age 11 years (SD: 3.3 years)) were consecutively recruited. The vast majority of participants (n=338; 89% were taking antiretroviral therapy (ART) for a median of 3 (IQR: 2-5) years at recruitment, and the most recent median CD4 Count (i.e. CD4 count measured within 6 months of the study recruitment) was 725 (IQR: 497-1000) cells/µL, with no difference by ART status. 61% (n= 231) of participants had an abnormal ear examination. Of the 359 participants who underwent audiometry, the prevalence of hearing impairment was 32.3% (95%CI: 27.5%-37.4%) based on a PTA threshold ≥26Db. Hearing impairment was associated with a recent CD4 count <350cell/µL (OR 2.1, P<0.037).
There is a high prevalence of hearing impairment among HIV-infected children and adolescents. Low CD4 count remains a risk factor even among those who are on ART. We recommend that HIV infected children and adolescents, particularly those with low CD4 counts, should have routine evaluation of hearing as part of HIV care.
在感染艾滋病毒的儿童中，耳部感染反复发作且呈慢性，可能导致听力丧失。
确定在哈拉雷接受艾滋病毒治疗的5至17岁感染艾滋病毒儿童中听力障碍的患病率、病因和严重程度。
在哈拉雷一家机会性感染诊所纽兰兹诊所进行的一项分析性横断面调查。
参与者接受了标准化的耳部耳镜检查和纯音听力测定（PTA）。使用多变量逻辑回归研究与听力障碍相关的因素。
连续招募了380名参与者（55%为女性，平均年龄11岁（标准差：3.3岁））。绝大多数参与者（n = 338；89%）在招募时正在接受抗逆转录病毒治疗（ART），中位数为3年（四分位间距：2 - 5年），最近的中位数CD4细胞计数（即在研究招募后6个月内测量的CD4细胞计数）为725（四分位间距：497 - 1000）个/微升，无论ART状态如何均无差异。61%（n = 231）的参与者耳部检查异常。在接受听力测定的359名参与者中，基于PTA阈值≥26分贝，听力障碍的患病率为32.3%（95%置信区间：27.5% - 37.4%）。听力障碍与最近的CD4细胞计数<350个/微升相关（比值比2.1，P < 0.037）。
感染艾滋病毒的儿童和青少年中听力障碍的患病率很高。即使在接受ART治疗的人群中，低CD4细胞计数仍然是一个危险因素。我们建议感染艾滋病毒的儿童和青少年，特别是那些CD4细胞计数低的儿童和青少年，应将听力的常规评估作为艾滋病毒治疗的一部分。
