The original publication is available at http://www.samj.org.zaBackground. Ototoxicity following aminoglycoside treatment
for multidrug-resistant tuberculosis (MDR-TB), is a significant
problem. This study documents the incidence of ototoxicity in HIVpositive
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 aminoglycosiderelated
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.Medical Research CouncilStellenbosch UniversitySouth African Society of Otorhinolarynogolog
