Hearing loss and antiretroviral therapy in patients infected with HIV-1

Objective: To explore the association between hearing loss and antiretroviral therapy in human immunodeficiency virus type 1 (HIV-1)-infected persons. Design: Case-control study. Setting: University-based HIV clinic. Participants: Volunteer sample of 99 HIV-infected patients. Interventions: Standardized interview focusing on risks for hearing loss, review of clinic pharmacy records, and hearing tests by portable audiometry. Main Outcome Measure: Hearing loss, defined as threshold of more than a 25-dB hearing level at 4000 Hz in 1 or both ears. Results: Hearing loss was common, seen in 29 subjects (29%). It was significantly associated with age and history of ear infection and tended to be more common in subjects prescribed antiretroviral agents. An interaction existed between age and antiretroviral therapy; the association between hearing loss and antiretroviral therapy was significant for subjects aged 35 years or older, but not for subjects younger than 35 years. In subjects aged 35 years or older, this association remained significant using a multivariate model that included those variables found to have the greatest potential for confounding (odds ratio, 4.6; 95% confidence interval, 1.0-20.5; P=.05). Conclusions: Hearing loss is common among HIV-infected individuals and is associated with antiretroviral therapy in those aged 35 years or older.