病毒学抑制的HIV感染者听力功能：HELO研究结果
Hearing function in virologically suppressed persons living with HIV: Results from the HELO study.
文献信息
| PMID | 42919792 |
|---|---|
| 原文 | 在 PubMed 查看原文 ↗ |
| 发表日期 | 2026 |
| 作者 | A Moulignier |
| 作者单位 | Department of Neurology, Adolphe de Rothschild Hospital Foundation, Paris, France; Infectious and Tropical Diseases Department, Sorbonne University, Assistance Publique-Hôpitaux de Paris, Tenon Hospital, Paris, France. Electronic address: amoulignier@for.paris. |
| 期刊 | European annals of otorhinolaryngology, head and neck diseases |
| SCI 分区 | Q2 |
| IF | 1.7 |
| 研究类型 | 临床研究 · 临床 |
| 所属专科 | 耳科 |
中文摘要
目的： 听力功能对衰老高度敏感，可能作为神经感觉衰退的标志物。控制良好的HIV感染是否与听觉功能改变相关仍不确定。
材料与方法： 横断面暴露-非暴露研究，纳入100例接受抗逆转录病毒治疗（ART）的HIV感染者（PLHIV）（感染≥10年且持续病毒抑制<20拷贝/mL≥5年）和95例年龄、性别匹配的HIV未感染对照（HUC）。所有参与者接受全面听力学评估，包括纯音测听、言语测听、听性脑干反应（ABR）和脑磁共振成像（MRI）。分析采用多变量模型对年龄进行调整。
目标： 评估长期、严格病毒学抑制的PLHIV与HUC相比的外周和脑干听觉功能。主要目标是比较听力较好耳的纯音听阈。
结果： 两组在纯音阈值、言语测听参数、ABR结果或MRI小血管病变特征方面未观察到有临床意义的差异。PLHIV平均气导阈值为26.4±10.2dB，HUC为27.1±9.8dB（P=0.52）。年龄调整分析显示，尽管HIV感染持续时间长，HIV状态与听觉结局之间无关联。ABR波潜伏期和峰间期在两组间相当。听觉指标与整体认知表现之间未发现显著相关性。虽然部分言语测听差异达到名义显著性水平，但均未达到为校正多重检验而预设的保守显著性阈值。
结论： 病毒学抑制的PLHIV与HUC的外周和脑干听觉功能相似。这些发现提示，在当前治疗条件下，控制良好的HIV感染与有临床意义的外周或脑干听觉功能障碍无关。不能完全排除细微的听觉改变，可能需要更敏感的纵向或噪声下言语评估。
英文摘要
AIM: Hearing function is highly sensitive to aging and may represent a marker of neuro-sensory decline. Whether well-controlled HIV infection is associated with altered auditory function remains uncertain.
MATERIAL AND METHODS: Cross-sectional exposed-non-exposed study including 100 antiretroviral therapy (ART)-treated persons living with HIV (PLHIVs) (≥10 years of infection and ≥5 years of sustained viral suppression <20 copies/mL) and 95 age- and sex-matched HIV-uninfected controls (HUCs). All participants underwent comprehensive audiological assessment including pure-tone audiometry, speech audiometry, auditory brainstem responses (ABR), and brain magnetic resonance imaging (MRI). Analyses were adjusted for age using multivariable models.
OBJECTIVES: To assess peripheral and brainstem auditory function in PLHIVs with long-term, tightly controlled virological suppression compared with HUCs. The primary objective was to compare pure-tone hearing thresholds in the better-hearing ear.
RESULTS: No clinically meaningful differences were observed between groups in pure-tone thresholds, speech audiometry parameters, ABR findings, or MRI small-vessel disease features. Mean air-conduction thresholds were 26.4±10.2dB in PLHIVs and 27.1±9.8dB in HUCs (P=0.52). Age-adjusted analyses showed no association between HIV status and auditory outcomes despite longstanding HIV infection. ABR wave latencies and interpeak intervals were comparable across groups. No significant correlation was found between auditory measures and global cognitive performance. Although some speech audiometry differences reached nominal significance levels, none met the predefined conservative significance threshold used to account for multiple testing.
CONCLUSION: Peripheral and brainstem auditory function were similar in virologically suppressed PLHIVs and HUCs. These findings suggest that, under current treatment conditions, well-controlled HIV infection is not associated with clinically meaningful peripheral or brainstem auditory dysfunction. Subtle auditory alterations cannot be completely excluded and may require more sensitive longitudinal or speech-in-noise assessments.