INTRODUCTION: Disorders of the auditory and vestibular system are often associated with human immunodeficiency
virus infection and acquired immunodeficiency syndrome. However, the extent and nature of these vestibular
manifestations are unclear.
OBJECTIVE: To systematically review the current peer-reviewed literature on vestibular manifestations and
pathology related to human immunodeficiency virus and acquired immunodeficiency syndrome.
METHOD: Systematic review of peer-reviewed articles related to vestibular findings in individuals with human
immunodeficiency virus infection and acquired immunodeficiency syndrome. Several electronic databases were
RESULTS: We identified 442 records, reduced to 210 after excluding duplicates and reviews. These were reviewed
for relevance to the scope of the study.
DISCUSSION: We identified only 13 reports investigating vestibular functioning and pathology in individuals
affected by human immunodeficiency virus and acquired immunodeficiency syndrome. This condition can affect
both the peripheral and central vestibular system, irrespective of age and viral disease stage. Peripheral vestibular
involvement may affect up to 50 per cent of patients, and central vestibular involvement may be even more
prevalent. Post-mortem studies suggest direct involvement of the entire vestibular system, while opportunistic
infections such as oto- and neurosyphilis and encephalitis cause secondary vestibular dysfunction resulting in
vertigo, dizziness and imbalance.
CONCLUSION: Patients with human immunodeficiency virus and acquired immunodeficiency syndrome should
routinely be monitored for vestibular involvement, to minimise functional limitations of quality of life.