Association of herpes simplex virus infection with hearing loss: a cross-sectional study using NHANES data from 2011 to 2012 and 2015 to 2016

Objectives To investigate the relationship between herpes simplex virus (HSV) and hearing loss using comprehensive population-based research.Design This cross-sectional study utilised data from the National Health and Nutrition Examination Survey (NHANES) to examine the relationship between HSV (types 1 and 2) and hearing loss. The final sample comprised 4608 participants aged 20-49 years. Weighted multivariate regression, subgroup and sensitivity analyses were employed for statistical evaluations.Setting Utilising the NHANES data, this cross-sectional study provides insights into the American population aged 20-49 years.Participants The study includes 4608 participants from the NHANES 2011-2012 and 2015-2016 cycles, focusing on those with complete data on HSV infection and hearing assessment.Interventions (exposure) The study analyses the association between HSV (types 1 and 2) infection and hearing loss, using weighted multivariate regression for statistical evaluations.Results We observed an association between HSV-1 infection and an increased likelihood of hearing impairment (OR, 1.4 (95% CI 1.1 to 1.9)). A similar association was noted for those coinfected with HSV-1 and HSV-2 (OR, 1.6 (95% CI 1.1 to 2.3)). Similarly, higher grades of hearing loss and elevated pure-tone averages were more prevalent in these groups. Notably, the association between HSV-1 and hearing impairment was more pronounced in individuals aged 20-34 (OR, 2.1 (95% CI 1.4 to 3.3); P for interaction=0.020) and those with a body mass index (BMI) below 30 (OR, 1.8 (95% CI 1.1 to 2.8); P for interaction=0.028).Conclusions Our findings suggest an association between HSV-1 infection or coinfections with HSV-1 and HSV-2 and the presence of hearing impairment. The association appears particularly pronounced among younger individuals and those with a lower BMI. Further prospective research is needed to explore the causal impact of HSV on auditory function.