Otologic and audiological evaluation among HIV patients in Ilorin, Nigeria

Abstract

Background: HIV infection is the highest cause of death worldwide and presenting eventually with ENT regions.

Objective: This study is to determine the prevalence of hearing loss and hearing patterns among adults Nigerians with HIV and causal relationships between CD4+ counts with the degree of hearing impairments.

Methods: This prospective study was carried out among all consecutive HIV positive patients attending the clinic at the University of Ilorin teaching hospital (U.I.T.H.), Ilorin, Nigeria between January and July, 2008. They all had audiological assessments with a pure tone audiometer within the frequency range 250 to 8,000Hz to determine their hearing thresholds together with their CD+ counts estimations.

Results: 89 were evaluated in the age range of 18 to 56 years (Mean 36.4 years, SD of 8.82) and the modal age group was 21-39 years (59.6%), 40-56 years (38.2%).There were 51 males (57.3%) and 38 females (42.7%) with a male/ female ratio of 1.3:1.0. Otological symptoms included tinnitus (15.7%), vertigo (15.7%), otalgia (14.6%) and hard of hearing (10%).

Examinations showed bilateral serous Otitis media (glue ear) in 58 patients (65.1%) with no affectation of the facial nerves. PTA showed mixed, conductive and SNHL in 32 patients (36%), 20 patients (22.5%), 9 patients (10.1%)
respectively and only 15 (16.9%) had normal hearing thresholds. The CD4+ counts ranged between 12 to 616. CD4 counts with hearing loss mostly < 300mm³.

Conclusion: The prevalence of hearing loss is 87% among HIV infected patients, mostly mixed HL with causal relationships between reduced CD4+ counts of less than 300/mm³ with severity of hearing loss. The hearing loss can interfere with the communication and specific knowledge vital to the development of best practices towards ensuring the inclusion of hearing impaired in HIV/AIDS prevention and treatment programmes .

Keywords: Hearing patterns; Pure tone Audiometry (PTA), CD4+ counts; Mixed hearing loss