Congenital CMV-infection and hearing loss

CMV (cytomegalovirus) is one of the Herpesviridae, known for their potential for latency and reactivation. The sequelae of fetal infection are diverse: chronic stage of early fetal infection with brain anomalies, symptomatic late fetal infection with hepatitis and thrombocytopenia and asymptomatic infection. With any of these clinical phenotypes, permanent hearing loss is possible. CMV-infection is the only relevant viral cause of perinatal hearing loss because rubella, measles and mumps have become rare due to vaccination. Recent studies have suggested beneficial effects on outcome of i.v. ganciclovir treatment in symptomatic cases. We have recently taken the challenge of treating asymptomatic newborns on the basis of active sonographic brain lesions in order to prevent labyrinth destruction. We would also like to stress the importance of suspecting children with congenital hearing loss, or hearing loss that develops in the first year of life, of having an asymptomatic congenital CMV-infection. Follow up in the first years of life is necessary in these children because further progression of hearing loss is possible.