Antiviral Treatment and Risk of Hearing Loss in Asymptomatic and Mild Symptomatic Infants with Congenital Cytomegalovirus.

Abstract

Background: To assess hearing outcomes at 24 months of age in infants with mild congenital cytomegalovirus (cCMV) infection, depending on whether they have received antiviral treatment or not Methods: A retrospective study within the European Registry of Children with cCMV was performed Included children had cCMV diagnosed in utero/in the first 21 days of life, with normal physical examination, alanine aminotransferase 100,000 cs/mm3 and absence of hearing loss (HL) at birth Cranial ultrasound (cUS) and/or cranial magnetic resonance imaging was normal or with minor findings (isolated lenticulostriate vasculopathy and/or germinolysis/caudothalamic or subependymal cysts, and/or focal/multifocal white matter involvement) The main outcome was the presence of HL at 24 months of age Results: One hundred ninety-six patients met inclusion criteria A total of 347% received antiviral treatment with valganciclovir/ganciclovir Children treated had lower gestational age, birth weight and head circumference, and maternal primary infection was less frequent Among treated children, 213% presented minor findings in cUS versus 63% in nontreatment group (P = 0003) Nine patients (46%) developed HL at 24 months Among children with HL, 20% presented minor findings in cUS versus 113% in non-HL group (P = NS) HL rate was similar in treated and nontreated groups (46% vs 63%; P = 06)