Pattern of hearing loss due to antiretroviral therapy in HIV infected adult patients at Kenyatta National Hospital.

Abstract

Introduction: Currently, there is increasing use of ARVs in Kenya, and more than 70,000 infected persons are on treatment, and the number increases day by day, especially with free treatment all over the country at the moment. While most of the side effects of ARV s have been found out, little is known about their ototoxicity. Aim: To determine if the patients on ARVs develop any significant hearing impairment compared to those who are not yet on ARVs. Setting: The comprehensive care clinic, KNH. Study Design: Case controlled study. Methodology: Two hundred and seventy-one (271) HIV positive patients on ARVs were recruited from the comprehensive care clinic at KNH. They underwent clinical examinations, otoscopy and Pure Tone Audiometry, to establish and characterize any present hearing loss. The PTA results were compared with those of two hundred and seventy- three (273) HIV negative patients who were not on ARV s. Cases were matched for age and sex. The CD4 cell counts of the patients were correlated with hearing levels, as well as the drug combinations and duration of ARVs use. The results were then analyzed using the statistical package for social sciences (SPSS) version 10.0.

Results: Hearing loss was found to be more in the control group (34%) than in the study group (28%). The most frequent hearing disorder was SNHL Jor both groups and majority of the patients had mild hearing loss. The frequencies most affected were the higher levels, 4 KHz and 8 KHz. There was a general increase in the hearing loss with increasing age, but this was not statistically significant, p < 0.05 (0.052). There was no significant correlation between hearing loss and CD4 levels in the study group, p > 0.05 (0.49) as well as between hearing loss and long-term use of ARVs, p > 0.05 (0.59).