Hearing Assessment in Infants Exposed to Human Immunodeficiency Virus

Background: Among the complications caused directly or indirectly by the Human Im-munodeficiency Virus (HIV), auditory system alterations stand out. The HIV exposed un-infected (HEU) children seem to have a higher risk of hearing loss (HL) when compared to their unexposed peers, but a lower risk when compared to those infected with HIV. How-ever, the literature is still not entirely clear on this association. This study aim to evaluate hearing function of HEU infants during the first months of life and correlate these findings with maternal, gestational, and neonatal variables. Methods: A prospective cohort study, including all infants HIV exposed, born in a quaternary hospital in southern Brazil from 2021 to 2023. Maternal, gestational, and neonatal data were collected, as well as neonatal auditory screening results. Around 6 months of age, otolaryngological and audiological assessments were conducted, including wideband tympanometry and electrophysiologi-cal evaluation using the Auditory Brainstem Response with frequency-specific stimulus. Results: Thirty-eight infants, mean age of 8 months (± 3.3), completed the study. Of these, 1 (2.6%) presented bilateral sensorineural HL, and 13 (34.2%) presented conductive HL, 6 cases unilateral and 7 bilateral. No associations were found between hearing loss and maternal, gestational, and neonatal variables, except for maternal CD4 count, where higher CD4 cell counts were associated with a higher risk of conductive HL.