PMID- 36920392 OWN - NLM STAT- MEDLINE DCOM- 20230320 LR - 20230405 IS - 2574-3805 (Electronic) IS - 2574-3805 (Linking) VI - 6 IP - 3 DP - 2023 Mar 1 TI - Peripheral Auditory Function in Tanzanian Children Living With HIV With Clinically Normal Hearing. PG - e233061 LID - 10.1001/jamanetworkopen.2023.3061 [doi] LID - e233061 AB - IMPORTANCE: Despite normal audiometry, adults living with HIV have lower distortion product otoacoustic emissions (DPOAEs) compared with HIV-negative controls, but the degree of these differences in children living with HIV is unknown. If subclinical auditory deficits are present, results could affect developmental outcomes in children living with HIV (CLWH). OBJECTIVE: To compare DPOAEs and auditory brainstem responses (ABR) between 2 age- and sex-matched groups of younger children with normal audiometry, 1 infected with HIV and the other uninfected. DESIGN, SETTING, AND PARTICIPANTS: Cohort study in an infectious disease center in Dar es Salaam, Tanzania. Participants included 340 Tanzanian children aged 3 to 9 years with clinically normal hearing, type A tympanograms bilaterally, and air-conduction thresholds of 20 dB HL or less from 0.5 to 8 kHz. Participants in the cohort repeated testing approximately every 6 months (approximately 2.2 sessions per participant) for a total of 744 total observations. Data were analyzed from March 2020 to January 2022. MAIN OUTCOMES AND MEASURES: DPOAE amplitudes from 1.5 to 8 kHz using an f2 to f1 ratio of 1.2 and L1/L2 values of 65/55 dB sound pressure level and click-evoked ABR using a slow (21.1/s) and fast (61.1/s) click rate. RESULTS: A total of 141 CLWH (70 female participants [49.3%]; mean [SD] age, 7.24 [1.67] years) and 199 HIV-negative individuals (99 female participants [49.7%]; mean [SD] age, 7.26 [1.44] years) participated in the study. The groups did not differ significantly in age, static immittance, or air-conduction thresholds. HIV status was independently associated with approximately 1.4 dB (95% CI, -3.28 to 0.30 dB) to 3.8 dB (95% CI, 6.03 to -1.99 dB) lower DPOAE amplitudes at 6 and 8 kHz bilaterally and 0.28 muV (95% CI, 0.01 to 0.33 muV) lower ABR wave V amplitudes in the right ear. CONCLUSIONS AND RELEVANCE: Consistent with previous findings in young adults, CLWH had slightly, but reliably, lower DPOAEs and ABR wave V amplitudes than HIV-negative controls. The magnitude of these differences was small, but results suggest an early and consistent association between HIV infection or treatment and outer hair cell and auditory brainstem responses in children as young as 3 years. These subclinical changes suggest tracking both auditory function and development outcomes in CLWH is warranted. FAU - Niemczak, Christopher E AU - Niemczak CE AD - Department of Medicine, Dartmouth-Hitchcock Medical Center, Lebanon, New Hampshire. AD - Space Medicine Innovations Laboratory, Geisel School of Medicine at Dartmouth, Hanover, New Hampshire. FAU - Ealer, Christin AU - Ealer C AD - Space Medicine Innovations Laboratory, Geisel School of Medicine at Dartmouth, Hanover, New Hampshire. FAU - Fellows, Abigail AU - Fellows A AD - Space Medicine Innovations Laboratory, Geisel School of Medicine at Dartmouth, Hanover, New Hampshire. FAU - Magohe, Albert AU - Magohe A AD - Muhimbili University of Health and Allied Sciences, Dar es Salaam, Tanzania. FAU - Gui, Jiang AU - Gui J AD - Department of Medicine, Dartmouth-Hitchcock Medical Center, Lebanon, New Hampshire. AD - Muhimbili University of Health and Allied Sciences, Dar es Salaam, Tanzania. FAU - Rieke, Catherine AU - Rieke C AD - Space Medicine Innovations Laboratory, Geisel School of Medicine at Dartmouth, Hanover, New Hampshire. FAU - Nicol, Trent AU - Nicol T AD - Auditory Neuroscience Laboratory, Department of Communication Sciences, Northwestern University, Evanston, Illinois. FAU - Massawe, Enica R AU - Massawe ER AD - Muhimbili University of Health and Allied Sciences, Dar es Salaam, Tanzania. FAU - Kraus, Nina AU - Kraus N AD - Auditory Neuroscience Laboratory, Department of Communication Sciences, Northwestern University, Evanston, Illinois. AD - Auditory Neuroscience Laboratory, Departments of Communication Sciences, Neurobiology and Otolaryngology, Northwestern University, Evanston, Illinois. FAU - Buckey, Jay C AU - Buckey JC AD - Department of Medicine, Dartmouth-Hitchcock Medical Center, Lebanon, New Hampshire. AD - Space Medicine Innovations Laboratory, Geisel School of Medicine at Dartmouth, Hanover, New Hampshire. LA - eng GR - R01 DC009972/DC/NIDCD NIH HHS/United States PT - Journal Article PT - Research Support, N.I.H., Extramural DEP - 20230301 PL - United States TA - JAMA Netw Open JT - JAMA network open JID - 101729235 SB - IM MH - Young Adult MH - Humans MH - Child MH - Female MH - *Otoacoustic Emissions, Spontaneous/physiology MH - Tanzania/epidemiology MH - *HIV Infections/complications MH - Cohort Studies MH - Audiometry, Pure-Tone MH - Auditory Threshold/physiology MH - Hearing PMC - PMC10018326 COIS- Conflict of Interest Disclosures: Dr Buckey reported a patent pending for systems and methods for analyzing frequency-following response to evaluate central nervous system function in participants with human immunodeficiency virus or nonhuman species analogues thereof. No other disclosures were reported. EDAT- 2023/03/16 06:00 MHDA- 2023/03/21 06:00 PMCR- 2023/03/15 CRDT- 2023/03/15 11:34 PHST- 2023/03/15 11:34 [entrez] PHST- 2023/03/16 06:00 [pubmed] PHST- 2023/03/21 06:00 [medline] PHST- 2023/03/15 00:00 [pmc-release] AID - 2802469 [pii] AID - zoi230124 [pii] AID - 10.1001/jamanetworkopen.2023.3061 [doi] PST - epublish SO - JAMA Netw Open. 2023 Mar 1;6(3):e233061. doi: 10.1001/jamanetworkopen.2023.3061.