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Published on: June 8, 2017
Neonatal screening for congenital cytomegalovirus infection and hearing loss
Maria Barbi1, Sandro Binda, Simona Caroppo
1Istituto di Virologia, Università di Milano, Via C. Pascal 38, 20133 Milano, Italy. maria.barbi@unimi.it
Insights
Congenital cytomegalovirus (CMV) infection is a leading cause of sensorineural hearing loss (SNHL) in infants. Neonatal screening programs could identify infected babies early for timely audiological monitoring and treatment.
Area of Science:
- Pediatrics
- Infectious Diseases
- Audiology
Background:
- Congenital cytomegalovirus (CMV) infection is a significant cause of congenital sensorineural hearing loss (SNHL), accounting for 20-30% of cases.
- Delayed identification of CMV-related hearing damage in infants, whether symptomatic or asymptomatic at birth, hinders effective treatment.
Purpose of the Study:
- To evaluate the feasibility of implementing a screening program for congenital CMV infection in newborns.
- To assess the potential benefits of audiological monitoring for congenitally infected infants.
Main Methods:
- This study is based on an opinion-review of existing literature and screening strategies.
- It considers the application of a nested PCR (polymerase chain reaction) test on dried blood spots (DBS) from newborns.
Main Results:
- The frequency and severity of hearing loss linked to congenital CMV suggest that neonatal screening campaigns are warranted.
- Existing universal neonatal audiological screening infrastructure can be leveraged for diagnosis and treatment.
Conclusions:
- A nested PCR test on dried blood spots (DBS test) shows promise for screening congenital CMV infection.
- Further cost-benefit analyses are necessary to weigh the expenses of screening, diagnosis, and follow-up against the gains in preventing hearing loss and reducing family burden.
Background:
Congenital cytomegalovirus infection causes 20-30% of congenital sensorineural hearing loss (SNHL) cases. Early identification of CMV attributable cases and their successful treatment are often hampered by the late appearance of the damage in a high proportion of children both symptomatic and asymptomatic at birth.
Objective:
To discuss the feasibility of a screening program aimed at finding congenitally infected babies followed by their audiological monitoring.
Study Design:
Opinion-review article.
Results And Conclusions:
Frequency and severity of hearing loss due to congenital CMV suggest it maybe worthwhile setting up neonatal screening campaigns. Structures where SNHL can be diagnosed and treated exist already in many countries as part of universal neonatal audiological screening schemes. A test based on viral DNA extraction from neonatal dried blood spots on Guthrie cards and its amplification by means of a nested PCR (DBS test) seems to offer the best characteristics for use in screening. Clearly it will be necessary to calculate whether the costs of screening, diagnosis and follow-up, and the financial and emotional burden on the families of infected children, are up to the potential gain.
