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Saturday, March 02, 2013

Increased Risk of Sudden Hearing Loss in HIV

Common signs and symptoms of HIV (human immunodeficiency virus) includes weight loss, fever, and a sickly appearance even though these are not universal problems in those infected with the condition. Hearing loss is usually not one of the first symptoms that comes to mind when thinking of HIV but is can happen in between 21 to 49% of cases.

There are three types of hearing loss. The first type is sensorineural hearing loss, which is caused by damage to the auditory nerve that transmits message to the ear, damage to the inner ear, or damage to parts of the brain that process sounds. When this occurs suddenly (over a period of a few hours to 3 days), it is known as sudden sensorineural hearing loss (SSHL). When it has been present for a long time, it is known as chronic sensorineural hearing loss. The second type of hearing loss is conductive hearing loss, in which there is a problem conducting sound waves anywhere along the path through the outer ear, eardrum, or middle ear. The third type of hearing loss is mixed-type hearing loss, which is a combination of the first two types.

The main causes of hearing loss in people with HIV are the direct effects of the virus (or other opportunistic infections) on the brain or auditory nerve and side effects of medications used to treat HIV. The sudden form of sensorineural hearing loss (SSHL) is believed to be rare in HIV but there has been no large scale study to on the topic in the English scientific literature.

In an upcoming study to be published in JAMA: Otolaryngology – Head and Neck Surgery, researchers performed such a large scale study with 8,760 HIV patients and 43,800 people without HIV over about a 6-year-period. The study participants were all from Taiwan. The results of the study showed that HIV patients between ages 18 and 35 had a 2.17 higher incidence of HIV compared to controls. The increased risk of SSHL was found to be especially true for men. No increased risk of SSHL was found in the HIV group for patients ages 36 or older for unclear reasons.

Suggested reading: The First Year: HIV: An Essential Guide for the Newly Diagnosed

Related blog entry: Contraceptive Use in Women with HIV

Reference: Lin C, Lin SW, Weng SF, Lin YS. (2013). Increased Risk of Sudden Sensorineural Hearing Loss in Patients With Human Immunodeficiency Virus Aged 18 to 35 Years: A Population-Based Cohort Study. JAMA Otolaryngol Head Neck Surg. 21:1-5.

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