Congenital Cytomegalovirus Infection as a Cause of Sensorineural Hearing Loss in a Highly Immune Population

Congenital Cytomegalovirus Infection as a Cause of Sensorineural Hearing Loss in a Highly Immune Population

Author Yamamoto, Aparecida Y. Google Scholar
Mussi-Pinhata, Marisa Marcia Google Scholar
Isaac, Myriam de Lima Google Scholar
Amaral, Fabiana R. Google Scholar
Carvalheiro, Cristina G. Google Scholar
Aragon, Davi C. Google Scholar
Silva Manfredi, Alessandra K. da Google Scholar
Boppana, Suresh B. Google Scholar
Britt, William J. Google Scholar
Institution Universidade Federal de São Paulo (UNIFESP)
Universidade de São Paulo (USP)
Univ Alabama
Abstract Background: the burden of congenital cytomegalovirus (CMV)-associated sensorineural hearing loss (SNHL) in populations with CMV seroprevalence approaching 100% is unknown. the purpose of this study was to assess the rate, associated factors, and predictors of SNHL in CMV-infected infants identified by newborn screening in a highly seropositive maternal population.Methods: Newborns with positive saliva CMV-DNA that was confirmed by virus isolation in the first 2 weeks of life were enrolled in a prospective follow-up study to monitor hearing outcome.Results: of 12,195 infants screened, 121 (1%) were infected with CMV and 12 (10%) had symptomatic infection at birth. Hearing function could be assessed in 102/121 children who underwent at least one auditory brainstem evoked response testing at a median age of 12 months. SNHL was observed in 10/102 (9.8%; 95% confidence interval: 5.1-16.7) children. Median age at the latest hearing evaluation was 47 months (12-84 months). Profound loss (>90 dB) was found in 4/5 children with bilateral SNHL while all 5 children with unilateral loss had moderate to severe deficit. the presence of symptomatic infection at birth (odds ratio, 38.1; 95% confidence interval: 1.6-916.7) was independently associated with SNHL after adjusting for intrauterine growth restriction, gestational age, gravidity, and maternal age. Among 10 infants with SNHL, 6 (60%) were born to mothers with nonprimary CMV infection.Conclusions: Even in populations with near universal immunity to CMV, congenital CMV infection is a significant cause of SNHL demonstrating the importance of CMV as a major cause of SNHL in children worldwide. As in other populations, SNHL is more frequently observed in symptomatic CMV infection.
Keywords cytomegalovirus
congenital infection
hearing loss
Brazilian children
Language English
Sponsor National Institutes of Health
Fogarty International Center
NIDCD
Fundação de Amparo à Pesquisa do Estado de São Paulo (FAPESP)
Grant number National Institutes of Health: NIAID AI 49537
Fogarty International Center: R03 TW006480
NIDCD: DC04162
FAPESP: 02/04166-6
Date 2011-12-01
Published in Pediatric Infectious Disease Journal. Philadelphia: Lippincott Williams & Wilkins, v. 30, n. 12, p. 1043-1046, 2011.
ISSN 0891-3668 (Sherpa/Romeo, impact factor)
Publisher Lippincott Williams & Wilkins
Extent 1043-1046
Origin http://dx.doi.org/10.1097/INF.0b013e31822d9640
Access rights Closed access
Type Article
Web of Science ID WOS:000297406100009
URI http://repositorio.unifesp.br/handle/11600/34311

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