Central Auditory Processing in Children is Affected by Perinatal HIV Exposure

Background: Children living with HIV are at higher risk for hearing loss compared to children with HIV-unexposed, uninfected (HUU). There is little known regarding the effects of children living with perinatally-acquired HIV (PHIV) and those living with perinatal HIV exposure but uninfected (PHEU) on central auditory function. Methods: Children 11–14 years old who were participating in the Auditory Research in Children with HIV study. Children were administered the dichotic digits test (DDT) to evaluate binaural integration as a part of a comprehensive hearing protocol. Scores were recorded as percent correct for each ear. Results: Data were collected on 268 children (102 HUU, 80 with PHEU and 86 with PHIV). Children with PHIV had the lowest median DDT for the right and left ears. After adjusting for age and grade level, children with PHIV had statistically significant 8-point lower DDT right ear percent correct (95% confidence interval [CI]: −13.69 to −1.86) and a 15-point lower DDT left ear percent correct (95% CI: −23.03 to −7.45) compared to HUU children. Children with PHEU did have slightly lower DDT scores bilaterally. In children living with PHIV, no HIV disease variables were significantly associated with DDT outcomes. Conclusions: Both peripheral hearing loss and central auditory function should be evaluated in children living with HIV. Children living with PHIV have poorer DDT outcomes compared with HUU children, while children living with PHEU had similar DDT outcomes to HUU children. Poorer binaural integration can have a significant impact on functional auditory performance and academic achievement.