Acharya Deepika, Hemal Alok, Tanwar Chetan S
Department of Pediatrics, Vardhman Mahavir Medical College and Safdarajung Hospital, New Delhi, IND.
Pediatrics, Dr. Ram Manohar Lohia Hospital, Delhi, IND.
Cureus. 2025 Mar 4;17(3):e80022. doi: 10.7759/cureus.80022. eCollection 2025 Mar.
The study aimed to assess the incidence of hearing loss (HL) in children with human immunodeficiency virus (HIV) using pure-tone audiometry and to find the association of HL with the duration of the disease and severity of HIV infection.
A cross-sectional study was done on 60 children in the age group of five to 18 years who presented to the anti-retroviral therapy (ART) clinic for follow-up. All children were confirmed cases of HIV by reverse transcription polymerase chain reaction (RT-PCR). For the study, all HIV-positive children were screened for any HL. Pure-tone audiometry was used for determining the hearing test. The degree and type of HL were assessed. The laterality of HL was assessed. The association of HL with the CD4 count and viral load was assessed. Mann-Whitney test, Fisher's exact test, and independent t-test were used for statistical analysis with a p-value < 0.05 being considered statistically significant.
HL was present in 10 (16.67%) cases, and all of them had conductive HL. Six cases had unilateral HL, while four cases had bilateral HL. In the majority (seven (70.00%)) of patients, the degree of HL was mild, followed by moderate HL (two (20.00%)) and minimal in only one (10.00%) patient. Compared to the HL- group, the HL+ group had significantly lower mean CD4 counts (483 ± 247.17 vs. 690.32 ± 301.09, p-value = 0.046) and significantly higher median viral load (2036.5 vs. 0, p < 0.0001). A significantly strong positive correlation was seen between the severity of HL with the viral load (r = 0.749, p = 0.018), and a significantly very strong negative correlation was seen between the severity of HL with CD4 counts (r = -0.809, p = 0.008).
An incidence rate of 16.67% HL was found among children with HIV. HL was predominantly mild in nature, and all cases had conductive HL. HL holds a direct correlation with increasing severity of HIV disease and subsequent falling of CD4 counts. Based on the results, it is recommended that all HIV-positive children must undergo routine audiology screening to determine the HL and provide them with audiological aid.
本研究旨在通过纯音听力测试评估人类免疫缺陷病毒（HIV）感染儿童的听力损失（HL）发生率，并找出HL与疾病持续时间及HIV感染严重程度之间的关联。
对60名年龄在5至18岁、前往抗逆转录病毒治疗（ART）门诊进行随访的儿童进行了一项横断面研究。所有儿童均通过逆转录聚合酶链反应（RT-PCR）确诊为HIV感染。在本研究中，对所有HIV阳性儿童进行了HL筛查。使用纯音听力测试来确定听力情况。评估了HL的程度和类型，以及HL的单侧或双侧情况。评估了HL与CD4细胞计数和病毒载量之间的关联。采用曼-惠特尼检验、费舍尔精确检验和独立t检验进行统计分析，p值<0.05被认为具有统计学意义。
10例（16.67%）存在HL，且均为传导性HL。6例为单侧HL，4例为双侧HL。大多数患者（7例（70.00%））HL程度为轻度，其次是中度HL（2例（20.00%）），仅1例（10.00%）患者为极轻度。与HL阴性组相比，HL阳性组的平均CD4细胞计数显著更低（483±247.17 vs. 690.32±301.09，p值=0.046），中位数病毒载量显著更高（2036.5 vs. 0，p<0.0001）。HL严重程度与病毒载量之间存在显著的强正相关（r=0.749，p=0.018），HL严重程度与CD4细胞计数之间存在显著的极强负相关（r=-0.809，p=0.008）。
在HIV感染儿童中发现HL发生率为16.67%。HL主要为轻度，且所有病例均为传导性HL。HL与HIV疾病严重程度增加及随后CD4细胞计数下降直接相关。根据研究结果，建议所有HIV阳性儿童必须接受常规听力筛查以确定是否存在HL，并为他们提供听力辅助设备。
