{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,4,28]],"date-time":"2026-04-28T08:33:25Z","timestamp":1777365205259,"version":"3.51.4"},"reference-count":18,"publisher":"Wiley","issue":"2","license":[{"start":{"date-parts":[[2011,11,29]],"date-time":"2011-11-29T00:00:00Z","timestamp":1322524800000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"content-domain":{"domain":["aao-hnsfjournals.onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Otolaryngol.--head neck surg."],"published-print":{"date-parts":[[2012,2]]},"abstract":"<jats:sec><jats:title>Objectives<\/jats:title><jats:p>To measure the prevalence and to identify risk factors of hearing impairment in human immunodeficiency virus\u2010infected children living in Peru.<\/jats:p><\/jats:sec><jats:sec><jats:title>Study design<\/jats:title><jats:p>Cross\u2010sectional observational study.<\/jats:p><\/jats:sec><jats:sec><jats:title>Setting<\/jats:title><jats:p>Two public hospitals and 1\u00a0nonprofit center in Lima, Peru, between August 2009 and April 2010.<\/jats:p><\/jats:sec><jats:sec><jats:title>Subjects<\/jats:title><jats:p>A total of 139 HIV\u2010infected children, ages 4 to 19 years.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>Hearing impairment and otologic health were assessed with pure tone audiometry, tympanometry, and otoscopy. The primary outcome was hearing loss, defined as average threshold &gt;25dB for 0.5, 1, 2, and 4\u00a0kHz, in one or both ears. Historical and socioeconomic information was obtained through parental survey and medical chart review. Statistical analysis included univariate analysis and multivariate logistic regression.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>Fifty\u2010four (38.8%) of 139 children had hearing impairment. On multivariate analysis, risk factors included: tympanic membrane perforation (odds ratio [OR] 7.08; 95% confidence interval [CI], 1.65\u201030.5; <jats:italic>P<\/jats:italic> =. 01), abnormal tympanometry (OR 2.71; 95% CI, 1.09\u20106.75; <jats:italic>P<\/jats:italic> =. 03), cerebral infection (OR 11.6; 95% CI, 1.06\u2010126; <jats:italic>P<\/jats:italic> =. 05), seizures (OR 5.20; 95% CI, 1.21\u201022.4; <jats:italic>P<\/jats:italic> =. 03), and CD4 cell count &lt;500 cells\/mm<jats:sup>3<\/jats:sup> (OR 3.53; 95% CI, 1.18\u201010.5; <jats:italic>P<\/jats:italic> =. 02).<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusions<\/jats:title><jats:p>The prevalence of hearing impairment in HIV\u2010infected children in Lima, Peru was 38.8%. Middle ear disease, prior cerebral infection, and low CD4 cell count were significantly associated with hearing impairment. The high prevalence of hearing impairment emphasizes the need for periodic hearing assessment in the routine clinical care of HIV\u2010infected children.<\/jats:p><\/jats:sec>","DOI":"10.1177\/0194599811429271","type":"journal-article","created":{"date-parts":[[2011,12,1]],"date-time":"2011-12-01T11:24:24Z","timestamp":1322738664000},"page":"259-265","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":41,"title":["High Prevalence of Hearing Impairment in HIV\u2010Infected Peruvian Children"],"prefix":"10.1002","volume":"146","author":[{"given":"Christina K.","family":"Chao","sequence":"first","affiliation":[{"name":"Department of Otolaryngology\u2010Head and Neck Surgery Stanford University School of Medicine Stanford California USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Josephine A.","family":"Czechowicz","sequence":"additional","affiliation":[{"name":"Department of Otolaryngology\u2010Head and Neck Surgery Stanford University School of Medicine Stanford California USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Anna H.","family":"Messner","sequence":"additional","affiliation":[{"name":"Department of Otolaryngology\u2010Head and Neck Surgery Stanford University School of Medicine Stanford California USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Jorge","family":"Alarc\u00f3n","sequence":"additional","affiliation":[{"name":"Universidad Nacional Mayor de San Marcos Lima Peru"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Lenka","family":"Kolevic Roca","sequence":"additional","affiliation":[{"name":"Instituto Nacional de Salud del Ni\u00f1o Lima Peru"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Marsi M.","family":"Larrag\u00e1n Rodriguez","sequence":"additional","affiliation":[{"name":"Hospital Nacional Arzobispo Loayza Lima Peru"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"C\u00e9sar","family":"Guti\u00e9rrez Villafuerte","sequence":"additional","affiliation":[{"name":"Universidad Nacional Mayor de San Marcos Lima Peru"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Silvia M.","family":"Montano","sequence":"additional","affiliation":[{"name":"US Naval Medical Research Center Detachment Lima Peru"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Joseph R.","family":"Zunt","sequence":"additional","affiliation":[{"name":"Departments of Neurology Global Health and Medicine (Infectious Diseases), and Epidemiology University of Washington Seattle Washington USA"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"311","published-online":{"date-parts":[[2011,11,29]]},"reference":[{"key":"e_1_2_9_2_2","doi-asserted-by":"publisher","DOI":"10.1111\/j.1365-2273.1992.tb01056.x"},{"key":"e_1_2_9_3_2","first-page":"35","article-title":"The ear in the acquired immunodeficiency syndrome: II. 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