Cochlear Implantation in Human Immunodeficiency Virus-Infected Patients

Objective: To evaluate the efficacy of cochlear implants in human immunodeficiency virus-infected individuals and correlate these results with a proposed pathophysiological mechanism of human immunodeficiency virus-associated hearing loss. Study Design: Retrospective case series and temporal bone analysis of deceased human immunodeficiency virus-positive patients. Setting: Tertiary care hospital. Patients: Seven human immunodeficiency virus-positive individuals with profound sensorineural hearing loss. Intervention: Cochlear implantation at New York University Medical Center. Methods: The surgical outcomes and complications were analyzed. Additionally, electron microscopic and immunohistochemical findings of cadaver temporal bone specimens of other known human immunodeficiency virus-positive individuals were reviewed. The performance results of the human immunodeficiency virus-positive cochlear implant patients were then correlated with the previously hypothesized pathophysiological mechanism of human immunodeficiency virus-associated hearing loss. Results: The patients had a varied performance with cochlear implantation, and as a group performance was good. There were no surgical complications or postoperative complications. The good performance of these patients supports the hypothesis that the mechanism of human immunodeficiency virus-associated deafness involves infiltration, malfunction, and premature degeneration of the hair cells and supportive cells of the cochlea. Conclusions: Human immunodeficiency virus-positive individuals benefit from cochlear implantation without increased surgical risk.