Central auditory processing in HIV-positive individuals

HIV 阳性个体的中枢听觉处理

• 批准号: 8547296
• 负责人: JAY C BUCKEY
• 金额: $ 35.35万
• 依托单位: DARTMOUTH COLLEGE
• 依托单位国家: 美国
• 财政年份: 2014
• 资助国家: 美国
• 起止时间: 2014-09-01 至 2017-08-31
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/8547296
• 关键词: AIDS/HIV problem; Acquired Immunodeficiency Syndrome; Address; Adverse effects; Aging; Algorithms; Anatomy; Anti-Retroviral Agents; Audiometry; Auditory; Auditory Brainstem Responses; Brain Stem; Cardiovascular Diseases; Central Auditory Processing Disorder; China; Chinese People; Clinic; Clinical; Cochlea; Control Groups; Databases; Defect; Detection; Disease; Drug Combinations; Enrollment; Environment; Evaluation; Exposure to; Funding; HIV; HIV Infections; HIV Seropositivity; Hearing; Hearing Tests; Indinavir; Individual; Infection; Inpatients; Knowledge; Lamivudine; Language; Lead; Link; Location; Lopinavir; Malignant Neoplasms; Measurement; Measures; Metabolic Diseases; Methods; Monitor; National Institute on Deafness and Other Communication Disorders; Neuraxis; Neurocognitive; Neurologic; Neurologic Manifestations; Nevirapine; Noise; Outpatients; Pathway interactions; Patient Self-Report; Patients; Performance; Peripheral; Pharmaceutical Preparations; Population; Prevalence; Process; Process Measure; Protocols documentation; Public Health; Questionnaires; RNA; Regimen; Reporting; Research; Response Latencies; Speech; Stavudine; System; Tanzania; Test Result; Testing; Toxin; Training; Treatment Protocols; Tympanometry; Universities; Update; Virus Replication; Zidovudine; abacavir; antiretroviral therapy; base; clinical practice; cohort; design; efavirenz; experience; improved; laptop; middle ear; otoacoustic emission; prevent; public health relevance; response; treatment center; treatment site; tuberculosis treatment

DESCRIPTION (provided by applicant): HIV positive individuals can develop hearing difficulties, but the location of the problem (e.g. middle ear, cochlea, central nervous system (CNS)) and the relationship to treatment has not been known. Results from our ongoing NIDCD-funded study in Tanzania show that patients on anti-retroviral therapy (ART) have findings consistent with a central auditory processing disorder. This suggests that (a) hearing deficits in HIV-positive individuals could be another neurocognitive side effect of HIV infection, (b) certain ART regimens might produce central nervous system side effects that manifest themselves as hearing difficulties, (c) some ART regimens may treat CNS HIV inadequately, which is reflected as a central hearing deficit, and/or (d) monitoring of central hearing parameters could be a method to track central effects of either HIV or ART. These findings need to be confirmed, expanded, and related definitively to particular treatment regimens. The objective of the proposed study is to assess central auditory processing (e.g. gap detection thresholds, auditory brainstem response, speech-in-noise thresholds) in a large cohort of HIV positive individuals at the main AIDS treatment site in Shanghai China. The combination of this audiological testing protocol, with the population under treatment in Shanghai, will provide a powerful combination to answer questions about central processing disorders in patients with HIV and to relate the findings to particular drug regimens. Our study will use a laptop-based hearing testing system that includes: native-language questionnaire administration for self-reported hearing capability and exposure to noise, drugs and toxins; threshold audiometry; adaptive gap detection testing; speech-in-noise testing in Mandarin; tympanometry; and auditory brainstem response testing to assess brainstem pathways. Testing will take place at the Shanghai Public Health Clinical Center--the AIDS treatment center for Shanghai, China. The center follows 2000 AIDS patients, offers both outpatient and inpatient treatment, is affiliated with Fudan University, and has a strong record of HIV research. We will place two integrated hearing testing systems at the center, and provide training in performing the testing. HIV negative, HIV positive individuals not on ART, and HIV positive individuals on a variety of different ART regimens will be enrolled, and studied with a central-auditory-processing-focused protocol. The combination of the hearing testing systems with the research-experienced, high-volume clinic in Shanghai, will provide an excellent environment to confirm and expand knowledge about the central auditory processing deficits in HIV infection, and ascertain whether these findings are related to the duration of infection or particular ART regimens. The information from this study may change how HIV positive are monitored and treated. The new methods developed for detecting central auditory processing deficits, such as the adaptive gap detection algorithm, may be useful for detecting and tracking neurocognitive changes in HIV positive patients.

描述（由申请人提供）：艾滋病毒阳性个体可以发展听力困难，但是问题的位置（例如中耳，耳蜗，中枢神经系统（CNS）），与治疗的关系尚不知道。我们正在进行的NIDCD资助的研究的结果表明，抗逆转录病毒疗法（ART）的患者的发现与中央听觉加工障碍一致。这表明（a）HIV阳性个体的听力不足可能是HIV感染的另一种神经认知副作用，（b）某些艺术方案可能会产生中枢神经系统副作用，表现为听力困难，（c）某些艺术方案可能会不充分地对待CNS HIV，这可能会反映出对中央听力障碍和（dement）的障碍或中央（D）的障碍，或者是extrive niver（d）的中央或nive him，或者是nimbles niver（d）的中央或nive him extriv the Orive trage the Oriv the Corniv the Oriv trage ofer（d）hiv trage ofer（d）hiv。 艺术。这些发现需要得到确认，扩展并与特定治疗方案明确相关。拟议的研究的目的是在中国上海的主要艾滋病治疗地点在大量的HIV阳性个体中评估中央听觉处理（例如差距检测阈值，听觉脑干响应，语音中的语言阈值）。该听力学测试方案的结合以及在上海接受治疗的人群将提供有力的组合，以回答有关HIV患者中央加工障碍的问题，并将发现与特定药物方案联系起来。 我们的研究将使用基于笔记本电脑的听力测试系统，其中包括：自我报告的听力能力和暴露于噪声，药物和毒素的本地语言调查表；阈值听力计；自适应间隙检测测试；普通话中的语音测试；鼓膜法；和听觉脑干反应测试，以评估脑干途径。测试将在上海上海上海上海艾滋病治疗中心进行测试。该中心遵循2000名AIDS患者，提供门诊和住院治疗，隶属于Fudan University，并具有较强的HIV研究记录。我们将在中心放置两个集成的听力测试系统，并提供进行测试的培训。艾滋病毒负面的艾滋病毒阳性人物不是在艺术上，艾滋病毒阳性人士将被纳入各种不同的艺术方案，并通过中央审计处理的方案进行了研究。听力测试系统与研究经验经验的高批量诊所的结合将为确认和扩大有关HIV感染中心听觉处理缺陷的知识的良好环境，并确定这些发现与感染的持续时间或特定的ART方案有关。这项研究的信息可能会改变如何监测和治疗艾滋病毒阳性。开发用于检测中央听觉处理缺陷的新方法，例如自适应差距检测算法，可能可用于检测和跟踪HIV阳性患者的神经认知变化。