Human papillomavirus (HPV) infection was associated with an increased risk for sudden sensorineural hearing loss (SSNHL), according to findings published in EClinicalMedicine.
According to the researchers, proposed mechanisms explaining the relationship between HPV infection and subsequent SSNHL included “direct viral invasion of the inner ear [or] …reactivation of latent virus within tissues of the inner ear,” and “a systemic viral infection that triggers an immune-mediated reaction or…stress response.”
Given these proposed etiologies, researchers conducted a population-based cohort study between January 2000 and December 2013 to determine whether HPV infection is associated with an increased risk for SSNHL. Patients with a prior diagnosis of HPV infection were propensity-score matched in a 1:2 fashion on the basis of age, sex, index year, and comorbidities against those with no history of HPV infection (controls). The primary outcomes included mortality and the time between initial HPV diagnosis and occurrence of SSNHL.
Among patients in the HPV (n=49,247) and control groups (n=98,494), the mean age was 33 years, the majority were women (51%), and the most common comorbidities included cervical disease, hypertension, and chronic liver disease.
The researchers found that patients in the HPV group were at increased risk for incident SSNHL vs those in the control group (incidence rate [IR], 3.24 vs 2.18 per 10,000 person-years). Similar results were observed after adjustment for patient characteristics, with a prior HPV diagnosis associated with a 37% increased risk for incident SSNHL (adjusted hazard ratio [aHR], 1.37; 95% CI, 1.07-1.74; P =.011).
Further analysis was conducted after stratification by age, sex, and comorbidities. For patients aged between 40 and 60 years, the risk for incident SSNHL was significantly increased among those in the HPV group vs those in the control group (IR, 5.44 vs 3.53; aHR, 1.50; 95% CI, 1.03-2.20; P =.037). Among patients in both groups, the occurrence of herpes simplex virus infection significantly increased the risk for incident SSNHL (aHR 1.78; 95% CI, 1.17-2.70).
A previous history of cerebrovascular disease was associated with a significantly increased risk for SSNHL among patients with HPV infection (aHR 4.59; 95% CI, 1.47-14.3; P =.009).
This study was limited as HPV and SSNHL diagnoses were made on the basis of diagnostic codes rather than clinical evaluation. Other limitations included potential confounding, limited generalizability, and that patients’ HPV vaccination status was not considered.
As these findings show that patients with HPV infection may be at increased risk for SSNHL, the researchers suggested a need for additional “…studies to explore the underlying mechanisms and to determine the potential efficacy of specific precautions.”
Chen TYT, Chang R, Hung YM, Yip HT, Wei JCC. Association between human papillomavirus infection and sudden sensorineural hearing loss: A nationwide population-based cohort study. EClinicalMedicine. 2022;47:101402. doi:10.1016/j.eclinm.2022.101402