Viral load in children with congenital cytomegalovirus infection identified on newborn hearing screening |
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| Institution: | 1. Department of Pediatrics, Nagoya University Graduate School of Medicine, Nagoya, Japan;2. Department of Obstetrics and Genecology, Nagoya University Graduate School of Medicine,Nagoya, Japan;3. Department of Virology, Nagoya University Graduate School of Medicine, Nagoya, Japan;1. Department of Microbiology and Immunology, Showa University, School of Medicine, 1-5-8 Hatanodai, Shinagawa-ku, Tokyo 142-8555, Japan;2. Research & Development Department, Shino-Test Corporation, 2-29-14 Oonodai, Sagamihara-shi, Kanagawa 229-0011, Japan;3. Department of Pediatrics, Showa University, School of Medicine, 1-5-8 Hatanodai, Shinagawa-ku, Tokyo 142-8666, Japan;4. Department of Pharmacogenomics, Showa University, School of Pharmaceutical Science, 1-5-8 Hatanodai, Shinagawa-ku, Tokyo 142-8555, Japan;1. Department of Pediatrics, the University of Alabama at Birmingham, Birmingham, AL;2. Department of Epidemiology, the University of Alabama at Birmingham, Birmingham, AL;3. Department of Microbiology, the University of Alabama at Birmingham, Birmingham, AL;1. Center for Public Policy & Administration, University of Utah, Salt Lake City, UT, United States;2. Department of Family & Consumer Studies, University of Utah, Salt Lake City, UT, United States;3. Utah Department of Health, Salt Lake City, UT, United States;4. Division of Otolaryngology—Head and Neck Surgery, University of Utah, Salt Lake City, UT, United States;1. National Center for Immunization and Respiratory Diseases, Centers for Disease Control and Prevention, Atlanta, Georgia;2. National Center on Birth Defects and Developmental Disabilities, Centers for Disease Control and Prevention, Atlanta, Georgia |
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| Abstract: | BackgroundCongenital cytomegalovirus (CMV) infection is the most common non-genetic cause of sensorineural hearing loss (SNHL) in children. However, congenital SNHL without other clinical abnormalities is rarely diagnosed as CMV-related in early infancy.ObjectivesThe aim of this study was to identify and treat patients with congenital CMV-related SNHL or CMV-related clinical abnormalities other than SNHL. The association between CMV load and SNHL was also evaluated.Study designNewborns who had abnormal hearing screening results or other clinical abnormalities were screened for congenital CMV infection by PCR of saliva or urine specimens, and identified infected patients were treated with valganciclovir (VGCV) for 6 weeks. The CMV load of patients with or without SNHL was compared at regular intervals during as well as after VGCV treatment.ResultsOf 127 infants with abnormal hearing screening results, and 31 infants with other clinical abnormalities, CMV infection was identified in 6 and 3 infants, respectively. After VGCV treatment, 1 case had improved hearing but the other 5 SNHL cases had little or no improvement. Among these 9 patients with or without SNHL at 1 year of age, there was no significant difference in CMV blood or urine load at diagnosis, but both were significantly higher in patients with SNHL during VGCV treatment.ConclusionsSelective CMV screening of newborns having an abnormal hearing screening result would be a reasonable strategy for identification of symptomatic congenital CMV infection. Prolonged detection of CMV in blood could be a risk factor for SNHL. |
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| Keywords: | Congenital cytomegalovirus infection Sensorineural hearing loss Valganciclovir Viral load |
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