المؤلفون: Yamamoto AY; Faculty of Medicine of Ribeirão Preto, Department of Pediatrics, University of São Paulo, São Paulo, Brazil. yulie@fmrp.usp.br, Mussi-Pinhata MM, Isaac Mde L, Amaral FR, Carvalheiro CG, Aragon DC, Manfredi AK, Boppana SB, Britt WJ

المصدر: The Pediatric infectious disease journal [Pediatr Infect Dis J] 2011 Dec; Vol. 30 (12), pp. 1043-6.

نوع المنشور: Journal Article; Research Support, N.I.H., Extramural; Research Support, Non-U.S. Gov't

بيانات الدورية: Publisher: Williams & Wilkins Country of Publication: United States NLM ID: 8701858 Publication Model: Print Cited Medium: Internet ISSN: 1532-0987 (Electronic) Linking ISSN: 08913668 NLM ISO Abbreviation: Pediatr Infect Dis J Subsets: MEDLINE

مواضيع طبية MeSH: Cytomegalovirus Infections/*congenital , Hearing Loss, Sensorineural/*virology, Brazil/epidemiology ; Cytomegalovirus Infections/complications ; Cytomegalovirus Infections/epidemiology ; Cytomegalovirus Infections/immunology ; Evoked Potentials, Auditory, Brain Stem ; Hearing Loss, Sensorineural/epidemiology ; Hearing Loss, Sensorineural/immunology ; Humans ; Infant, Newborn ; Saliva/virology

مستخلص: 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.