HIV and TB therapy
Currently approximately 25 million people in South Africa (SA)
are HIV-positive.[13] Hearing loss can be caused by HIV and/or
its treatment; both are implicated in sensorineural hearing loss.[7]
Treatment aimed at opportunistic infections and antineoplastic
therapy can have synergistic hearing effects on patients receiving
ARVs.[7,8] TB therapy is one such treatment, and TB is an increasing
problem in sub-Saharan Africa owing to co-infection with HIV.
There are increasing numbers of cases of multidrug-resistant
(MDR) TB in SA,[8,14] the treatment of which involves injectable
aminoglycosides that are known to cause ototoxicity[8,15] via a
synergistic ototoxic effect together with ARVs on the outer hair cells
of the cochlea, leading to high-frequency sensorineural hearing loss
(HFSNHL).[15]