Congenital cytomegalovirus: association between dried blood spot viral load and hearing loss

Walter, Simone; Atkinson, Claire; Sharland, Mike; Rice, Philip; Raglan, Ewa; Emery, Vincent C.; Griffiths, Paul

doi:10.1136/adc.2007.119230

Cited by 117 publications

(87 citation statements)

References 38 publications

(38 reference statements)

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“…Symptomatic infection; disseminated disease, especially with petechiae and intrauterine growth retardation; and a high viral load at birth seem to be associated with hearing loss. 75,[105][106][107] Identification of risk factors might be helpful for a more directed and rigorous follow-up of infants at risk for hearing loss. Furthermore, it might decrease the number of dropouts in longitudinal followup of asymptomatic infants.…”

Section: Discussionmentioning

confidence: 99%

Hearing Loss and Congenital CMV Infection: A Systematic Review

Goderis¹,

Leenheer²,

et al. 2014

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BACKGROUND AND OBJECTIVE: Hearing loss caused by congenital cytomegalovirus (cCMV) infection was first observed in 1964. Today cCMV is the most common cause of nonhereditary sensorineural hearing loss in childhood. Our objective was to provide an overview of the prevalence of cCMV-related hearing loss, to better define the nature of cCMV-associated hearing loss, and to investigate the importance of cCMV infection in hearing-impaired children. METHODS:Two reviewers independently used Medline and manual searches of references from eligible studies and review articles to select cohort studies on children with cCMV infection with audiological follow-up and extracted data on population characteristics and hearing outcomes. RESULTS:Thirty-seven studies were included: 10 population-based natural history studies, 14 longitudinal cohort studies, and 13 retrospective studies. The prevalence of cCMV in developed countries is 0.58% (95% confidence interval, 0.41-0.79). Among these newborns 12.6% (95% confidence interval, 10.2-16.5) will experience hearing loss: 1 out of 3 symptomatic children and 1 out of 10 asymptomatic children. Among symptomatic children, the majority have bilateral loss; among asymptomatic children, unilateral loss predominates. In both groups the hearing loss is mainly severe to profound. Hearing loss can have a delayed onset, and it is unstable, with fluctuations and progression. Among hearing-impaired children, cCMV is the causative agent in 10% to 20%. Despite strict selection criteria, some heterogeneity was found between selected studies.CONCLUSIONS: This systematic review underscores the importance of cCMV as a cause of sensorineural hearing loss in childhood. Pediatrics 2014;134:972-982

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Section: Discussionmentioning

confidence: 99%

Hearing Loss and Congenital CMV Infection: A Systematic Review

Goderis¹,

Leenheer²,

et al. 2014

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“…Dried blood spots (DBS), or Guthrie cards, which are collected routinely at birth in certain countries for newborn genetic and metabolic diseases screening, can be stored for extended periods of time. Since CMV DNA is stable on such DBS cards for up to 18 years, they offer an attractive tool for the retrospective molecular diagnosis of congenital infection in individual children who present with delayed-onset sequelae (112)(113)(114)(115). DBS also have appeal for use in newborn congenital CMV screening programs.…”

Section: Advances In Diagnosis and Management Of The Newbornmentioning

confidence: 99%

The “Silent” Global Burden of Congenital Cytomegalovirus

et al. 2013

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SUMMARYHuman cytomegalovirus (CMV) is a leading cause of congenital infections worldwide. In the developed world, following the virtual elimination of circulating rubella, it is the commonest nongenetic cause of childhood hearing loss and an important cause of neurodevelopmental delay. The seroprevalence of CMV in adults and the incidence of congenital CMV infection are highest in developing countries (1 to 5% of births) and are most likely driven by nonprimary maternal infections. However, reliable estimates of prevalence and outcome from developing countries are not available. This is largely due to the dogma that maternal preexisting seroimmunity virtually eliminates the risk for sequelae. However, recent data demonstrating similar rates of sequelae, especially hearing loss, following primary and nonprimary maternal infection have underscored the importance of congenital CMV infection in resource-poor settings. Although a significant proportion of congenital CMV infections are attributable to maternal primary infection in well-resourced settings, the absence of specific interventions for seronegative mothers and uncertainty about fetal prognosis have discouraged routine maternal antibody screening. Despite these challenges, encouraging results from prototype vaccines have been reported, and the first randomized phase III trials of prenatal interventions and prolonged postnatal antiviral therapy are under way. Successful implementation of strategies to prevent or reduce the burden of congenital CMV infection will require heightened global awareness among clinicians and the general population. In this review, we highlight the global epidemiology of congenital CMV and the implications of growing knowledge in areas of prevention, diagnosis, prognosis, and management for both low (50 to 70%)- and high (>70%)-seroprevalence settings.

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“…Значимость абсолютного уровня репликации ци-томегаловируса, полученного с помощью количе-ственного метода ПЦР, до конца не выяснена. В ряде исследований показана связь вирусной нагрузки в крови/моче с развитием симптоматического ва-рианта врожденной цитомегаловирусной инфекции и последующей тугоухости [36][37][38]. Украинские ав-торы (2013) продемонстрировали корреляцию вы-сокой вирусной нагрузки (более 5·10 3 копий в 1 мл мочи, полученной в родильном зале) с повышением риска нарушений нервно-психического развития и слуха к возрасту 1 года [39].…”

Section: клиническая картина и диагностика врожденной цитомегаловирусunclassified