Middle Ear Function in Human Immunodeficiency Virus (HIV)-Infected South African Children

Abstract

Children with human immunodeficiency virus (HIV) infection are more likely to have hearing loss and are more susceptible to middle ear infections. The purpose of this study was to quantitatively measure middle ear function, using tympanometry, in perinatally HIV-infected (PHIV) and HIV-uninfected children living in Cape Town, South Africa.Hearing-related health questionnaire data were obtained before testing. Bilateral otoscopy and tympanometry were completed in 37 PHIV and 24 HIV-uninfected children. Otoscopy was performed to evaluate debris in ear canals and to observe the tympanic membrane. Ear canal volume (Vec), peak acoustic admittance (peak Ytm), and tympanogram peak pressure (TPP) were obtained. Presence of outer and middle ear pathologies was determined. Data were compared between PHIV and HIV-uninfected children. Parent/ caregiver report of past middle ear infection was higher in PHIV children (34.2%) compared with HIV-uninfected children (25.0%). Risk for reported history of middle ear infection was higher in PHIV children classified as World Health Organization (WHO) stage IV compared to other WHO stages. Outer ear otorrhea was present in two PHIV children and no HIV- uninfected children. There were no significant differences for Vec, Ytm, and TPP between PHIV and HIV-uninfected children. Tympanometry data for PHIV and HIV-uninfected children were similar, although PHIV children had a higher rate of outer ear otorrhea.