Viral load in children with congenital cytomegalovirus infection identified on newborn hearing screening

Kawada, Junji; Torii, Yuka; Kawano, Yoshihiko; Suzuki, Michio; Kamiya, Yushi; Kotani, Tomomi; Kikkawa, Fumitaka; Kimura, Hiroshi; Ito, Yoshinori

doi:10.1016/j.jcv.2015.01.015

Cited by 35 publications

(23 citation statements)

References 23 publications

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“…All of these studies screened infants who failed their initial newborn hearing screen. One prospective cohort study21 identified six infants with cCMV and SNHL. All infants were treated with valganciclovir for 6 weeks, with only one child experiencing an improvement in hearing at 1 year of age.…”

Section: Discussionmentioning

confidence: 99%

Does screening for congenital cytomegalovirus at birth improve longer term hearing outcomes?

et al. 2018

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Currently, the diagnosis of congenital cytomegalovirus (cCMV) infection in most highly resourced countries is based on clinical suspicion alone. This means only a small proportion of cCMV infections are diagnosed. Identification, through either universal or targeted screening of asymptomatic newborns with cCMV, who would previously have gone undiagnosed, would allow for potential early treatment with antiviral therapy, ongoing audiological surveillance and early intervention if sensorineural hearing loss (SNHL) is identified. This paper systematically reviews published papers examining the potential benefits of targeted and universal screening for newborn infants with cCMV. We found that the treatment of these infants with antiviral therapy remains controversial, and clinical trials are currently underway to provide further answers. The potential benefit of earlier identification and intervention (eg, amplification and speech therapy) of children at risk of later-onset SNHL identified through universal screening is, however, clearer.

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Section: Discussionmentioning

confidence: 99%

Does screening for congenital cytomegalovirus at birth improve longer term hearing outcomes?

et al. 2018

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“…CMV genome load in urine decreased to 614 copies/mL at the end of 6 weeks of treatment and did not increase after treatment was completed. The increase of viral loads in blood was observed after completion of ganciclovir therapy, but we did not treat this because the rebound increase of the CMV genome load was reported in earlier report and exacerbation of clinical findings was not observed (16). We assume that the decline in CMV viral load in blood and urine reflects a favorable response to treatment.…”

mentioning

confidence: 86%

Congenital Cytomegalovirus Pneumonitis and Treatment Response Evaluation Using Viral Load during Ganciclovir Therapy: a Case Report

et al. 2018

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“…It would also enable an earlier identification and correction of the main cause of hearing loss with post-natal onset [5]. If, for any reason, a neonatal cCMV screening is not feasible on a large scale, at least a hearing-targeted cCMV screening should be set up: it would allow the early identification of children with cCMV-related hearing loss, although it would miss delayed hearing losses or other cCMV-related disease [3, 4, 9]. The following benefits from hearing-targeted CMV screening can be underlined; i) it would provide an accurate assessment of the aetiology of childhood deafness, helping physicians in children’s management and follow-up; ii) it would allow an adequate counselling and support to parents; iii) it would help predicting whether another child might be born with hearing-linked damages and, finally, iv) it could alert clinicians on the possible neurological and behavioural complications.…”

Section: Discussionmentioning

confidence: 99%

“…A wide range of diseases, diagnosed either at birth or in childhood, has been correlated to cCMV infection [1]; sensorineural hearing loss is the most frequent permanent damage, occurring in 5–40% of infected children, either symptomatic or not at birth; as a matter of fact, cCMV is the most common cause of non-genetic deafness in childhood [2]. An early identification of infected children – ideally through a universal neonatal screening - might allow a prompt treatment, aimed at limiting the hearing loss progression and possibly preventing the onset of cCMV-linked damages to the central nervous system in both symptomatic and asymptomatic babies [3, 4]. …”

Section: Introductionmentioning

confidence: 99%

Diagnosis of congenital CMV infection via DBS samples testing and neonatal hearing screening: an observational study in Italy

et al. 2019

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Background Congenital Cytomegalovirus (cCMV) is the most common cause of non-genetic hearing loss in childhood. A newborn hearing screening program (NHSP) is currently running in Italy, but no universal cCMV nor statewide hearing-targeted CMV screening programs have been implemented yet. This observational monocentric study was aimed at estimating the rate of cCMV infections identified by CMV-DNA analysis on Dried Blood Spots (DBS) samples in deaf children identified via NHSP in Northern Italy in the period spanning from 2014 to 2018. Methods Children with a confirmed diagnosis of deafness and investigated for CMV-DNA by nucleic acid extraction and in-house polymerase-chain reaction (PCR) on stored newborns screening cards (DBS-test) were included in this study. Deafness was defined by a hearing threshold ≥20 decibel (dB HL) by Auditory Brainstem Responses (ABR); all investigated DBS samples were collected within 3 days of life. Results Overall, 82 children were included (median age: 3.4 months; lower-upper quartiles: 2–5.3 months; males: 60.9%). Most of them (70.7%) presented bilateral hearing loss with a symmetrical pattern in 79.3% of the cases. ABR thresholds were ≥ 70 dB HL (severe/profound deafness) in 46.5% of children. Among all tested children, 6.1% resulted positive for cCMV. The rate of severe/profound deafness was statistically higher in children with cCMV infection. Conclusions The addition of DBS-test to the NHSP allowed the identification, in their first months of life, of a cCMV infection in 6.1% of children who had failed NHS. The introduction of a targeted CMV screening strategy could help clinicians in the differential diagnosis and in the babies’ management. DBS samples can be considered a “universal newborns biobank”: their storage site and duration should be the subject of political decision-making.

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Viral load in children with congenital cytomegalovirus infection identified on newborn hearing screening

Cited by 35 publications

References 23 publications

Does screening for congenital cytomegalovirus at birth improve longer term hearing outcomes?

Does screening for congenital cytomegalovirus at birth improve longer term hearing outcomes?

Congenital Cytomegalovirus Pneumonitis and Treatment Response Evaluation Using Viral Load during Ganciclovir Therapy: a Case Report

Diagnosis of congenital CMV infection via DBS samples testing and neonatal hearing screening: an observational study in Italy

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