HIV and AIDS
HIV and AIDS of the ear may lead to impairment in quality of life. It may even be life threatening. Human immunodeficiency virus (HIV) and the acquired immunodeficiency syndrome (AIDS) is a worldwide pandemic that affects the lives of millions of people.
There are 37 million people in the world living with HIV. This roughly equates to the population of Poland (38 million). 1, 2 million people died of AIDS in 2014, a number that is down by 42% since 2004. The overall HIV infection rate is also down by 35% since 2000. Although this is promising, showing that awareness campaigns and anti retro-viral therapy (ART) are working it is concerning to know that only 54% of infected patients actually know that they are!
HIV and AIDS commonly present with head and neck manifestations. It can affect the ear and its central connections to the brain. This involvement occurs on different levels from the outer ear to the brain. This result is ear infections, tumours, hearing loss, dizziness, facial nerve palsy, tinnitus and loss of balance.
The effect that HIV and AIDS has on the hearing and balance (audio vestibular) system may be due to the HIV virus itself, concomitant infections by other organisms such as tuberculosis and side effects of ARV’s and other medication used in treatment.
All patients with HIV and AIDS should be examined for audio vestibular involvement. With the increase in survival rate of patients more emphasis should be put on quality of life issues. Hearing impairment and balance problems impair quality of life.
Management is diverse, and depends on the problem and the cause. The primary HIV infection is managed with anti- retroviral therapy. Concomitant infections need antibiotic or anti microbal therapy. Grommets may be required in patients with persistent fluid in the middle ear. HIV and AIDS patients with tuberculosis often develop hearing loss as a complication of the anti tuberculosis treatment. A cochlear implantation (CI) may be of great benefit in these patients and surgery is not contra indicated, depending on a low viral load.
If you are HIV positive have your hearing tested, especially when you note a change. Children with HIV should all be tested. If you have any dizziness or balance problems consult someone as this may be treatable.
Systematic review of vestibular disorders related to human immunodeficiency virus and acquired immunodeficiency syndrome