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Use of In vivo Imaging to Monitor the Progression of Experimental Mouse Cytomegalovirus Infection in Neonates
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"Minimally symptomatic" congenital cytomegalovirus infection: latest data and emerging concepts

Ashley Howard1,2, Javier K Nishikawa3, Pablo J Sánchez4

  • 1Department of Pediatric Infectious Diseases and Immunology, Connecticut Children's Hospital, Hartford, Connecticut.

Current Opinion in Pediatrics
|May 15, 2024
PubMed

Insights

Newborn screening for congenital cytomegalovirus (CMV) is rising. Antiviral therapy may help hearing in some infants, but those without symptoms should not be treated.

Area of Science:

  • Virology
  • Neonatal Medicine
  • Public Health

Background:

  • Congenital cytomegalovirus (CMV) infection screening in newborns is expanding globally.
  • Management strategies for infants with congenital CMV, particularly those with mild or no symptoms, require clarification.

Purpose of the Study:

  • To review the current management of neonates with congenital CMV infection.
  • To focus on infants with minimal symptoms or subclinical infection, including those with sensorineural hearing loss (SNHL).

Main Methods:

  • Review of current clinical practices and recent studies on congenital CMV management.
  • Analysis of antiviral treatment efficacy and outcomes in neonates.

Main Results:

  • Valganciclovir is increasingly used for congenital CMV in neonates, showing potential hearing improvements up to 2 years.
  • Treatment initiated early (first month) is recommended for symptomatic infants.
  • Therapy started at 1-3 months improved hearing in infants with inapparent CMV and isolated SNHL.

Conclusions:

  • Antiviral therapy (ganciclovir/valganciclovir) offers moderate benefit in preventing hearing decline in symptomatic infants or those with SNHL.
  • Long-term benefits of antiviral therapy beyond 2 years are unknown.
  • Infants with clinically inapparent CMV infection and normal evaluations should not receive antiviral treatment.
  • All infants with congenital CMV require ongoing audiological and neurodevelopmental monitoring.
Abstract

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