Aminoglycoside-induced hearing loss in HIV-positive and HIV-negative multidrug-resistant tuberculosis patients

Department of Otolaryngology, Kimberley Hospital Complex
South African medical journal = Suid-Afrikaanse tydskrif vir geneeskunde (Impact Factor: 1.63). 06/2012; 102(6):363-6.
Source: PubMed


Background. Ototoxicity following aminoglycoside treatment for multidrug-resistant tuberculosis (MDR-TB) is a significant problem. This study documents the incidence of ototoxicity in HIV-positive and HIV-negative patients with MDR-TB and presents clinical guidelines relating to ototoxicity. Methods. A prospective cohort study of 153 MDR-TB patients with normal hearing and middle ear status at baseline controlling for 6 mitochondrial mutations associated with aminoglycoside-related ototoxicity, at Brooklyn Chest Hospital in Cape Town. Pure tone audiometry was performed monthly for 3 months to determine hearing loss. HIV status was recorded, as was the presence of 6 mutations in the MT-RNR1 gene. Results. Fifty-seven per cent developed high-frequency hearing loss. HIV-positive patients (70%) were more likely to develop hearing loss than HIV-negative patients (42%). Of 115 patients who were genetically screened, none had MT-RNR1 mutations. Conclusion. Ototoxic hearing loss is common in MDR-TB patients treated with aminoglycosides. HIV-positive patients are at increased risk of ototoxicity. Auditory monitoring and auditory rehabilitation should be an integral part of the package of care of MDR-TB patients.

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Available from: Lucretia Petersen, Mar 20, 2015
    • "Preferential damage to tissue types varies by the specific aminoglycoside employed [8] [30] [64]. Nonetheless, because of their low cost, high efficacy, and low incidence of resistance, aminoglycoside antibiotics are commonly used in many parts of the world today including South Africa and the United States [2] [7] [29] [35]. Aminoglycosides have been commonly prescribed for sepsis, meningitis, complicated urinary tract and respiratory infections because they were highly effective against gram-negative infections [52]. "
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