Otologic and audiological evaluation among HIV patients in Ilorin, Nigeria.

B S Alabi, A K Salami, O A Afolabi, S K Aremu, H O Olawumi, L O Odeigah, H J Akande
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Abstract

Background: HIV infection is the highest cause of death worldwide and presenting eventually with ENT regions.

Objective: This study is to determine the prevalence of hearing loss and hearing patterns among adults Nigerians with HIV and causal relationships between CD4+ counts with the degree of hearing impairments.

Methods: This prospective study was carried out among all consecutive HIV positive patients attending the clinic at the University of Ilorin teaching hospital (U.I.T.H.), Ilorin, Nigeria between January and July, 2008. They all had audiological assessments with a pure tone audiometer within the frequency range 250 to 8,000 Hz to determine their hearing thresholds together with their CD+ counts estimations.

Results: 89 were evaluated in the age range of 18 to 56 years (Mean 36.4 years, SD of 8.82) and the modal age group was 21-39 years (59.6%), 40-56 years (38.2%).There were 51 males (57.3%) and 38 females (42.7%) with a male/female ratio of 1.3:1.0. Otological symptoms included tinnitus (15.7%), vertigo (15.7%), otalgia (14.6%) and hard of hearing (10%). Examinations showed bilateral serous Otitis media (glue ear) in 58 patients (65.1%) with no affectation of the facial nerves. PTA showed mixed, conductive and SNHL in 32 patients (36%), 20 patients (22.5%), 9 patients (10.1%) respectively and only 15(16.9%) had normal hearing thresholds. The CD4+ counts ranged between 12 to 616. CD4 counts with hearing loss mostly < 300mm3.

Conclusion: The prevalence of hearing loss is 87% among HIV infected patients, mostly mixed HLwith causal relationships between reduced CD4+ counts of less than 300/mm3 with severity of hearing loss. The hearing loss can interfere with the communication and specific knowledge vital to the development of best practices towards ensuring the inclusion of hearing impaired in HIV/AIDS prevention and treatment programmes.

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尼日利亚伊洛林艾滋病毒患者的耳科和听力学评估。
背景:艾滋病毒感染是世界范围内死亡的最高原因,并最终出现在耳鼻喉科地区。目的:本研究旨在确定尼日利亚成年HIV感染者中听力损失的患病率和听力模式,以及CD4+计数与听力损害程度之间的因果关系。方法:对2008年1月至7月在尼日利亚伊洛林市伊洛林大学教学医院(U.I.T.H.)门诊就诊的所有HIV阳性患者进行前瞻性研究。他们都用250到8000 Hz频率范围内的纯音听力计进行了听力学评估,以确定他们的听力阈值以及他们的CD+计数估计。结果:共89例患者,年龄18 ~ 56岁,平均36.4岁,标准差8.82,主要年龄为21 ~ 39岁(59.6%),40 ~ 56岁(38.2%)。男性51例(57.3%),女性38例(42.7%),男女比例为1.3:1.0。耳科症状包括耳鸣(15.7%)、眩晕(15.7%)、耳痛(14.6%)和听力困难(10%)。检查显示双侧浆液性中耳炎(胶耳)58例(65.1%),面神经未受影响。其中32例(36%)、20例(22.5%)、9例(10.1%)的PTA表现为混合性、传导性和SNHL,仅有15例(16.9%)听力阈值正常。CD4+计数在12到616之间。听力损失患者CD4计数多< 300mm3。结论:HIV感染者中听力损失发生率为87%,以混合性肝炎为主,CD4+计数低于300/mm3与听力损失严重程度有因果关系。听力损失可能干扰沟通和特定知识,而这对于制定最佳做法以确保将听力受损者纳入艾滋病毒/艾滋病预防和治疗规划至关重要。
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