Potential Benefit of Selective CMV Testing after Failed Newborn Hearing Screening

Abstract

Evidence-based guidelines for the prevention, diagnosis and treatment of congenital cytomegalovirus (cCMV) were recently released by two independent expert groups. Of particular emphasis was the relationship between cCMV and sensorineural hearing loss (SNHL), a major component of the virus’ overall disease burden. In this study, a literature review was performed to estimate the proportion of cCMV-related SNHL cases, which might be identified through selective cCMV testing following failed newborn hearing screening. Furthermore, it was of interest to estimate the potential benefit of emerging antiviral therapies. Currently, at most 10% of cCMV-related SNHL is likely to be identified clinically. Through use of a selective cCMV testing protocol, however, a significant improvement in the identification rate can be achieved. Recent expert group statements strongly recommend antiviral therapy in cases of moderate-to-severe disease, especially in the presence of central nervous system involvement. Though differences exist between recommendations in instances of isolated SNHL or SNHL in combination with only mild symptoms, the majority of experts in both groups offered at least a weak recommendation for antiviral treatment. Available results suggest antiviral treatment could therefore benefit a meaningful proportion of newborns referred for cCMV testing following failed newborn hearing screening.

Burden of sequelae and healthcare resource utilization in the first year of life in infants born with congenital cytomegalovirus (cCMV) infection in Germany: A retrospective statutory health insurance claims database analysis

“…It may be reasonable to suggest testing for cCMV infection in infants with unexplained intrauterine growth retardation at birth or prematurity [28]. Targeted CMV testing among newborns who failed newborn hearing screening, has been explored by different study groups [29,30]. The study by Fowler et al [29] evaluated a group of newborns specifically screened for CMV, who underwent newborn hearing screening in the follow-up.…”

“…Access to the data used in this study can only be provided to external parties under the conditions of the cooperation contract of this research project and can be assessed upon request, after written approval at InGef GmbH (Tel. +49 (30) 21 23 36-471; info@ingef.de), if required.…”

Newborn Hearing Screening and Intervention in Children with Unilateral Hearing Impairment: Clinical Practices in Three Nordic Countries

“…Some, however, would test for cCMV infection if SSD was suspected but not for UHI. Given that cCMV infection is associated with any degree of HI [ 57 ], it is recommended that all children who fail the screening are screened for cCMV [ 58 ]. Thus, this should apply to children with any degree of UHI and those with SSD.…”

Keypoints to Successful Newborn Hearing Screening. Thirty Years of Experience and Innovations

“…Early diagnosis is important for considering drug treatment with ganciclovir or valganciclovir, given that several studies have shown their usefulness for improving hearing loss or preventing its progression in these children. For a congenital diagnosis it is necessary to have a positive PCR test in urine before 21 postnatal days and that is the reason for doing retest in hearing screening before this date [30][31][32].…”