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).
Citation
Degree of Master of Medicine in ENT, head and neck surgery, University of NairobiPublisher
Department of surgery
Description
This dissertation is submitted in partial fulfillment of the requirements
for the Degree of Master of Medicine in ENT, head and neck surgery,
University of Nairobi.