A prospective study of hearing changes after beginning zidovudine or didanosine in HIV-1 treatment-naïve people

Jeffrey T Schouten,Ann C Collier,Christina M Marra,Thomas S Rees,David W Lockhart

doi:10.1186/1471-2334-6-28

Abstract

BackgroundWhile hearing loss in HIV-infected people after beginning nucleoside reverse transcriptase inhibitors (NRTIs) has been reported, there have been no prospective studies that measured hearing changes longitudinally in treatment-naïve HIV-infected subjects following initiation of regimens containing NRTIs. The goal of this study was to conduct a prospective assessment of the contribution of zidovudine (ZDV) and didanosine (ddI) to hearing lossMethods/designA prospective observational pilot study to determine whether ZDV or ddI, alone or in combination, are associated with sensorineural hearing loss in HIV-infected persons. Changes in hearing levels at all frequencies and in low and high frequency pure tone averages were measured at baseline, 16, and 32 weeks after initiating antiretroviral therapy.DiscussionTreatment with ZDV and ddI did not result in loss of hearing, even after taking into account noise exposure, immune status and age. The results of this prospective pilot study do not support the notion that treatment with nucleoside antiretrovirals damages hearing.

Highlights

While hearing loss in HIV-infected people after beginning nucleoside reverse transcriptase inhibitors (NRTIs) has been reported, there have been no prospective studies that measured hearing changes longitudinally in treatment-naïve HIV-infected subjects following initiation of regimens containing NRTIs
Treatment with ZDV and ddI did not result in loss of hearing, even after taking into account noise exposure, immune status and age. The results of this prospective pilot study do not support the notion that treatment with nucleoside antiretrovirals damages hearing
In a prior cross sectional study, we showed that hearing loss was common in HIV-infected people and was associated with older age and antiretroviral use, but we were unable to determine an association with specific antiretroviral agents [1]

Summary

Introduction

While hearing loss in HIV-infected people after beginning nucleoside reverse transcriptase inhibitors (NRTIs) has been reported, there have been no prospective studies that measured hearing changes longitudinally in treatment-naïve HIV-infected subjects following initiation of regimens containing NRTIs. Cross-sectional studies and case reports show that hearing loss may be common among HIV-infected people [1,2,3]. Hearing loss may be associated with HIV infection itself, opportunistic infections, or ototoxic drug therapy [1]. In up to 50% of HIV-infected people with hearing loss, no cause can be identified [4]. In a prior cross sectional study, we showed that hearing loss was common in HIV-infected people and was associated with older age and antiretroviral use, but we were unable to determine an association with specific antiretroviral agents [1]. The goal of this study was to conduct a prospective assessment of the contribution of zidovudine (ZDV) and didanosine (ddI) to hearing loss

Objectives

Methods

Findings

Conclusion