Otologic and audiologic evaluation of human immunodeficiency virus-infected patients

Purpose: To quantify the incidence of ear disease in patients infected with human immunodeficiency virus (HIV). Materials and Methods: This is a descriptive case series of HIV-positive pa tients, with data collected using an otologic questionnaire, otologic exami nation, audiologic evaluation, and chart review. The study was performed at an urban University Hospital's outpatient Infectious Disease and Otolaryng ology clinics. A consecutive sample of 50 HIV-infected patients volunteered for this study. Ten subjects refused. Almost all patients received public assistance for medical care. Descriptive results were tabulated. Audiometri c data were analyzed for ear, Centers for Disease Control (CDC) group, otol ogic complaint, and age effects. Data were compared with established norms. Results: Twenty-three men and 27 women with a mean age of 40 years and mean duration of HIV disease of 3.5 years were studied. Eighteen percent of pat ients were in category CDC-A, 38% in CDC-B, and 44% in CDC-C. Otologic comp laints were more prevalent than expected: 34% of patients reported aural fu llness, 32% dizziness, 29% hearing loss, 26% tinnitus, 23% otalgia, and 5% otorrhea. Results of the neuro-otologic examination were abnormal in 33%. T ympanometric examination was abnormal in 21%. A significant degree of high- frequency sensorineural hearing loss was observed. CDC-B and CDC-C patients had worse hearing than CDC-A patients at 3 frequencies. Patients who compl ained of hearing loss had significantly worse otoacoustic emission results and hearing results than patients who did not, at all frequencies except 1, 000 Hz. Patients in their 30s had better hearing in the speech frequencies than did all other patients. Conclusions: Ear disease affects up to 33% of HIV-infected patients. Otitis media is a frequent finding. Sensorineural hearing loss is more severe in patients with more severe HIV infection. Patients with ear complaints have demonstrable otopathology. Continuation of this preliminary descriptive wor k is necessary. (Am J Otolaryngol 2000;21:1-9. Copyright (C) 2000 by W.B. S aunders Company).