Torre Peter, Russell Jonathan S, Smith Renee, Hoffman Howard J, Lee Sonia, Williams Paige L, Yao Tzy-Jyun
School of Speech, Language, and Hearing Sciences, San Diego State University, CA.
Center for Biostatistics in AIDS Research, Harvard T. H. Chan School of Public Health, Boston, MA.
Am J Audiol. 2020 Mar 5;29(1):68-78. doi: 10.1044/2019_AJA-19-00042. Epub 2020 Jan 31.
Purpose The purpose of this study was to compare Words-in-Noise (WIN) data between young adults with perinatal HIV (PHIV) infection and those with PHIV exposure but uninfected (PHEU) and to evaluate associations between antiretroviral therapy (ART) exposures and WIN data. Method The WIN test and cognitive function were assessed in participants of the Pediatric HIV/AIDS Cohort Study Adolescent Master Protocol Up. Impaired WIN (IWIN) performance was defined as a signal-to-babble ratio of > +10 dB. Cognitive function was determined based on fluid cognition composite scores (FCCSs) and crystallized cognition composite scores, and < 70 was considered a fluid or crystallized cognitive impairment. Log binomial models were used to calculate the relative risks of IWIN between PHIV and PHEU. Results PHIV ( = 334) and PHEU ( = 52) participants had similar WIN thresholds and IWIN percentages. For young adults with FCCS ≥ 70, participants with PHIV were less likely to have IWIN for the better ear and worse ear as compared to participants with PHEU. For young adults with FCCS < 70, there was no association between HIV status and risk of IWIN for the better ear or worse ear. For those adults with crystallized cognition composite score of ≥ 70, young adults with PHIV were less likely to have IWIN for the better ear than young adults with PHEU; there was no association between HIV status and IWIN for the worse ear. For young adults with PHIV without a Centers for Disease Control and Prevention Class C diagnosis, a longer combination ART duration was associated with a higher risk of IWIN for the better ear. Conclusions For those without cognitive impairment, young adults with PHEU had poorer WIN thresholds than those young adults with PHIV. In young adults with PHIV who had no prior Centers for Disease Control and Prevention Class C diagnosis, a longer combination ART duration was associated with IWIN only in the better ear.
目的 本研究旨在比较围产期感染人类免疫缺陷病毒(PHIV)的年轻成年人与暴露于PHIV但未感染(PHEU)的年轻成年人之间的噪声中言语(WIN)数据,并评估抗逆转录病毒疗法(ART)暴露与WIN数据之间的关联。方法 在儿科HIV/艾滋病队列研究青少年主方案升级版的参与者中评估WIN测试和认知功能。WIN表现受损(IWIN)定义为信号与杂音比> +10 dB。认知功能根据流体认知综合评分(FCCS)和晶体认知综合评分确定,<70被视为流体或晶体认知障碍。使用对数二项模型计算PHIV和PHEU之间IWIN的相对风险。结果 PHIV组(n = 334)和PHEU组(n = 52)参与者的WIN阈值和IWIN百分比相似。对于FCCS≥70的年轻成年人,与PHEU参与者相比,PHIV参与者的较好耳和较差耳出现IWIN的可能性较小。对于FCCS <70的年轻成年人,HIV状态与较好耳或较差耳的IWIN风险之间没有关联。对于晶体认知综合评分≥70的成年人,PHIV年轻成年人的较好耳出现IWIN的可能性低于PHEU年轻成年人;HIV状态与较差耳的IWIN之间没有关联。对于没有疾病控制和预防中心C类诊断的PHIV年轻成年人,较长的联合ART持续时间与较好耳出现IWIN的风险较高相关。结论 对于没有认知障碍的人,PHEU年轻成年人的WIN阈值比PHIV年轻成年人差。在没有先前疾病控制和预防中心C类诊断的PHIV年轻成年人中,较长的联合ART持续时间仅与较好耳的IWIN相关。