Vestibular involvement in adults with HIV/AIDS

Abstract

OBJECTIVE : HIV/AIDS is responsible for widespread clinical manifestations involving the head, and neck.The prevalence and nature of vestibular involvement is still largely unknown. This study, aimed to describe and compare the occurrence and nature of vestibular involvement among a group of, adults infected with HIV compared to a control group. It also aimed to compare the vestibular function, of symptomatic and asymptomatic HIV positive adults who receive antiretroviral (ARV) therapies to,subjects not receiving ARV. METHODS : A cross-sectional study was conducted on 53 adults (29 male, 24 female, aged 23–49 years,mean = 38.5, SD = 4.4) infected with HIV, compared to a control group of 38 HIV negative adults (18,male, 20 female, aged 20–49 years, mean = 36.9, SD = 8.2). A structured interview probed the subjective,perception of vestibular symptoms. Medical records were reviewed for CD4+ cell counts and the use of, ARV medication. An otologic assessment and a comprehensive vestibular assessment (bedside,assessments, vestibular evoked myogenic potentials, ocular motor and positional tests and bithermal,caloric irrigation) were conducted. RESULTS : Vestibular involvement occurred in 79.2% of subjects with HIV in all categories of disease,progression, compared to 18.4% in those without HIV. Vestibular involvement increased from 18.9% in CDC category 1 to 30.2% in category 2. Vestibular involvement was 30.1% in category 3. There were,vestibular involvement in 35.9% of symptomatic HIV positive subjects, and 41.5% in asymptomatic, HIV positive subjects. There was no significant difference in the occurrence of vestibular involvement, in subjects receiving ARV therapies compared to those not receiving ARV therapies (p = .914; chi-square,test). The odds ratio indicates that individuals with HIV have a 16.61 times higher risk of developing,vestibular involvement during their lifetime of living with the disease and that it may occur despite,being asymptomatic. CONCLUSION : Vestibular involvement was significantly more common in subjects with HIV. Primary health care providers could screen HIV positive patients to ascertain if there are symptoms of vestibular involvement. If there are any, then they may consider further vestibular assessments and subsequent vestibular rehabilitation therapy.