Hearing function in virologically suppressed persons living with HIV: Results from the HELO study - 24/10/26

Doi : 10.1016/j.anorl.2026.07.015

A. Moulignier ^a,^b,⁎ , M. Daval ^c, J. Guillaume ^d, J. Rodach ^c, N. Valin ^e, D. Ayache ^c

^a Department of Neurology, Adolphe de Rothschild Hospital Foundation, Paris, France

^b Infectious and Tropical Diseases Department, Sorbonne University, Assistance Publique–Hôpitaux de Paris, Tenon Hospital, Paris, France

^c Department of Otololaryngology—Head and Neck Surgery, Adolphe de Rothschild Hospital Foundation, Paris, France

^d Clinical Research Unit, Adolphe de Rothschild Hospital Foundation, Paris, France

^e Infectious and Tropical Diseases Department, Sorbonne University, Assistance Publique–Hôpitaux de Paris, Saint Antoine Hospital, Paris, France

^⁎ Corresponding author. Department of Neurology, Hôpital Fondation Adolphe de Rothschild, 29, rue Manin, 75019 Paris, France. Department of Neurology, Hôpital Fondation Adolphe de Rothschild 29, rue Manin Paris 75019 France

Sous presse. Épreuves corrigées par l'auteur. Disponible en ligne depuis le Saturday 24 October 2026

Abstract

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 ± 10.2 dB in PLHIVs and 27.1 ± 9.8 dB 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.

Le texte complet de cet article est disponible en PDF.

Keywords : HIV, Hearing loss, Audiometry, Auditory brainstem responses, Aging