A Central Auditory Test reveals differences between drug treatment regimens in adults living with HIV.
Christopher E Niemczak, Yi Zhan, Junkun Ren and 8 others
PMID 36662150WHAT IT FOUND
People living with HIV on a regimen containing zidovudine had worse speech-in-noise perception than those on tenofovir, even after adjusting for age and hearing loss.
This suggests central auditory tests might help detect subtle cognitive effects of different HIV drug regimens.
Key findings
01Participants on Regimen B (efavirenz, lamivudine, zidovudine) had significantly worse composite speech-in-noise scores compared to Regimen A (efavirenz, lamivudine, tenofovir).
02Speech-in-noise performance was an independent predictor of cognitive impairment on the MoCA, although the association was weak and not robust in sensitivity analyses.
03The difference in speech-in-noise perception persisted after statistically adjusting for age, HIV duration, and peripheral hearing loss.
STILL TO COME
How it was doneWhat they foundWhat it means for SLPs
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What it does not show
This was an exploratory analysis of existing data not originally designed to test this specific hypothesis. The two groups differed significantly at baseline: Regimen B participants were older and had longer HIV durations, which are known risk factors for cognitive decline. Adherence to medication was not measured, so differences in outcomes could be due to how well patients took their drugs rather than the drugs themselves. The study only used one type of central auditory test (speech-in-noise), so it cannot generalize to other aspects of auditory processing. The association between speech-in-noise scores and cognitive impairment was weak and failed to hold up in sensitivity analyses.
Declared interests
The authors declared no conflicts of interest. The study was supported by NIH funding.
The easy way to misread this
Do not conclude that zidovudine causes hearing or cognitive problems. The group taking zidovudine was older and had HIV longer than the other group, and these factors strongly influence test results. The study shows an association, not a direct cause.