Considerations for cochlear implantation in adults with Human Immunodeficiency Virus (HIV)

Abstract

Previous observational studies have demonstrated that Human Immunodeficiency Virus (HIV)-positive (HIVpos) cochlear implant (CI) recipients are functional CI users, but have provided limited information regarding HIV-specific preoperative considerations, such as health status, pneumococcal vaccination, CD4+ cell count and viral load status. This study aimed to describe candidacy, audiological and surgical considerations for cochlear implantation in adults with HIV by reviewing data from a larger sample of HIVpos adult CI recipients.

A retrospective chart review was employed for this study. Retrospective data (demographical, hearing loss, CI, medical and surgical data) was captured from the clinical patient files at two South African CI centres, namely the Pretoria Cochlear Implant Unit (PCIU) and the Johannesburg Cochlear Implant Centre (JCIC).

The clinical patient files of 14 post-lingually deafened adult CI recipients (9 females and 5 males, mean age= 42.14 years, SD= 8.08; range= 23-50 years), were reviewed to describe preoperative CI candidacy considerations, cochlear implantation and surgical considerations, as well as postoperative audiological and medical considerations.

Results of this study indicated that all 14 patients performed well with their cochlear implants, including two patients with a history of preoperative meningitis, three patients with less than 100% adherence to the recommended HIV-specific guidelines and one patient with postoperative electrode migration. A comprehensive preoperative audiological and medical test battery, adherence to current South African HIV-specific CI guidelines and a highly individualized surgical and medical risk assessment approach were efficacious in selecting the current PLWHA for CI surgery. HIV-specific considerations for determining CI candidacy in PLWHA were suggested to ensure functional postoperative outcome after cochlear implantation.