Hearing loss in children and adolescents with HIV/Aids.

Author(s)

Aline Medeiros da Silva

• Document type: Doctoral Thesis
• Press: São Paulo.
• Institution: Universidade de São Paulo (USP). Faculdade de Saúde Pública (FSP/CIR)
• Defense date: 2011-03-29

Examining board members

Maria do Rosario Dias de Oliveira Latorre; Maria Célia Cervi; Ana Claudia Fiorini; Carla Gentile Matas; Aluisio Augusto Cotrim Segurado

• Advisor: Maria do Rosario Dias de Oliveira Latorre; Heloísa Helena de Sousa Marques

Abstract

Introduction Children and adolescents living with HIV/Aids may suffer from a variety of hearing problems which are more frequent and sometimes more severe when compared to other children. Aim To estimate the prevalence of hearing loss and risk factors in children and adolescents attending at the Childrens Institute (ICr). Methods 106 patients (5 19 years) were analyzed. Patients and caregivers answered several questionnaires about demographic and clinical conditions. Subsequently, the visual inspection of the external auditory meatus was performed in order to verify if there were clinical conditions to perform the audiologic evaluation. The audiologic evaluation was conducted using pure tone audiometry, speech audiometry, tympanometry and tests of acoustic reflexes. The statistical analysis was done using descriptive statistics, Kappa statistics, Students t-test, chi-square test and univariate and multiple logistic regression models. Results The prevalence of hearing loss according to the Bureau Internacional d´Audio Phonologie (BIAP) classification and to the American Speech-Language-Hearing Association (ASHA) classification was 35.8per cent and 59.4per cent, respectively. The agreement in the diagnosis of hearing loss was good between BIAP and ASHA (k= 0.55). The only risk factor for hearing loss for both classifications was the occurrence of suppurative otitis media. For the BIAP classification, the use of lamivudine (3TC) was a risk factor for hearing loss. For the ASHA classification, the occurrence of severe illness, specially encephalopathy, was a risk factor for hearing loss. Conclusions The occurrence of suppurative otitis media, the history of a severe disease, specially encephalopathy, and the use of lamivudine effectively contribute to hearing loss in children and adolescents with HIV/Aids. Auditory monitoring is critical because it allows early detection of hearing loss and identification of its progression. It is highly recommended periodic hearing assessments (AU)