15 January 2015 

Assessments of hearing may be needed for some HIV-positive people

Researchers in the U.S. have collaborated on a study that assessed hearing problems among HIV-negative and HIV-positive people. The researchers found that some HIV-positive people were more likely to have difficulty hearing both high and low frequencies. There was no connection between the use of anti-HIV drugs and hearing loss. The implications of the present study are discussed later in this CATIE News bulletin.

Study details

Researchers recruited 396 adults for this study. They were distributed as follows:


  • 117 HIV-positive
  • 145 HIV-negative


  • 105 HIV-positive
  • 29 HIV-negative

The average profile of participants was as follows:

  • age – 50 years
  • duration of HIV therapy – 17 years
  • CD4+ count – 577 cells/mm3
  • CD8+ count – 865 cells/mm3
  • HIV viral load – 50 copies/ml

Participants underwent ear examinations and sophisticated assessments of their ability to hear sounds. They were also interviewed by study personnel about their hearing and medical history, particularly about the presence of diabetes and disturbances in thyroid hormone levels, as these can affect hearing.

Researchers compared hearing assessments within genders; that is, HIV-positive men were compared to HIV-negative men.


The study team reported that, overall, HIV-positive people had some degree of hearing loss compared to HIV-negative people of the same age, gender, race and exposure to noise levels (due to occupation and recreation).

Specifically, when it came to higher frequencies, HIV-positive people tended to have “poorer hearing sensitivity”—a decrease in hearing sensitivity of 18% compared to HIV-negative people. For lower frequencies, HIV-positive people had a decrease of about 12% compared to HIV-negative people. These differences were statistically significant; that is, not likely due to chance alone.

Not connected

The study team did not find any link between hearing loss and the following factors:

  • CD4+ or CD8+ cell counts
  • HIV viral load
  • a history of AIDS
  • years of exposure to any group of anti-HIV drugs

Why HIV?

Previous studies have generally found a degree of hearing loss among HIV-positive people. In the present study, researchers do not understand precisely why HIV infection may be associated with hearing loss, so expect more studies in the future that seek to explore this link.

Don’t forget syphilis

The U.S. researchers did not specifically mention the syphilis status of participants. This may be important. In a previous report, doctors in Toronto documented at least eight cases of ear-related abnormalities, including tinnitus (ringing in the ears), hearing loss and dizziness (the inner ear helps regulate balance), among HIV-positive people. In all of these cases, doctors made a diagnosis of syphilis, and in half of the cases they made a diagnosis of neurosyphilis. Patients were treated with intensive and prolonged regimens of penicillin and all reported recovery from tinnitus. Four patients also reported improved hearing.

Key points

  1. A reasonably designed study has found significant differences in hearing between HIV-positive and HIV-negative people.
  2. Participants were middle-aged and the researchers did not expect such people to experience a loss of hearing of lower frequencies.
  3. In theory, the loss of some hearing capacity could affect the ability of some HIV-positive people to understand words and communication accurately. However, this theory needs to be tested in another study.
  4. People who experience problems with hearing and/or balance should seek evaluation by a doctor.

About hearing loss

There are many possible causes of hearing loss, and any change in hearing that affects a person’s quality of life or ability to work or engage in everyday activities needs to be reported to a doctor so it can be investigated.

According to the Mayo Clinic, symptoms of hearing loss may include the following:

  • difficulty following conversation, particularly in crowds where there is background noise
  • speech and sounds may seem muffled
  • needing to increase the volume of a TV, radio, MP3 player or other audio device
  • asking other people to speak more slowly, clearly and loudly
  • difficulty hearing consonants
  • withdrawing from conversation
  • avoiding some social situations because of difficulties understanding speech

In cases where doctors have found that hearing loss cannot be reversed, they may prescribe the use of hearing aids.

—Sean R. Hosein


  1. Torre P 3rd, Hoffman HJ, Springer G, et al. Hearing loss among HIV-seropositive and HIV-seronegative men and women. JAMA Otolaryngology—Head & Neck Surgery. 2015; in press.
  2. Cohen BE, Durstenfeld A, Roehm PC. Viral causes of hearing loss: a review for hearing health professionals. Trends in Hearing. 2014;18;1-17.
  3. Mishra S, Walmsley SL, Loutfy MR, et al. Otosyphilis in HIV-coinfected individuals: a case series from Toronto, Canada. AIDS Patient Care and STDs. 2008 Mar;22(3):213-9.