Vestibular and oculomotor abnormalities among HIV-infected and HIV-uninfected men and women: A pilot study.

To determine if middle-aged and aging men and women with HIV disease (HIV+) should be screened for vestibular and oculomotor dysfunction. Age- and sociodemographically matched HIV+ and HIV- men and women were tested on vestibular evoked myogenic potential (VEMP), bi-thermic caloric testing, Dix-Hallpike maneuvers and saccades. HIV+ men had more caloric weakness than HIV- men. HIV+ subjects had more saccade abnormalities than HIV- subjects. A saccade abnormality was positively associated with being HIV+. Among the HIV+ sample, abnormalities were associated with increasing age, being male, ever taking monotherapy, and having an undetectable viral load. Only being male and having an undetectable viral load were statistically significant. Unilateral caloric weakness had a decreased prevalence with age per 10 years, and being HIV+ showed an increased prevalence. In HIV+ subjects only, these abnormalities decreased with age and being male but increased with undetectable viral load and ever taking antiretroviral monotherapy. No statistically significant differences were found. Women are at greater risk of vestibular and oculomotor abnormalities than men. HIV+ adults are at greater risk than HIV- adults. Physicians who care for HIV+ men and women should monitor the symptoms of vestibular and oculomotor impairment.