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Hearing Loss in Infants and Children with Asymptomatic Congenital Cytomegalovirus Infection: An Update in Diagnosis,

Yiyun Zhang1, Yihan Ke1, Mengwen Shi1

  • 1Department of Otorhinolaryngology, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan 430022, China.

Diagnostics (Basel, Switzerland)
|August 28, 2025
PubMed

Insights

Congenital cytomegalovirus (CMV) infection often presents asymptomatically in newborns but can lead to significant late-onset hearing loss and neurodevelopmental issues. Early screening and management are crucial for these infants.

Area of Science:

  • Pediatrics
  • Infectious Diseases
  • Audiology

Background:

  • Congenital cytomegalovirus (CMV) is the most common congenital viral infection and a leading cause of non-genetic sensorineural hearing loss (SNHL) in children.
  • Most congenitally infected infants are asymptomatic at birth, leading to underdiagnosis and delayed identification of potential long-term sequelae.
  • Current research often overlooks asymptomatic cases, despite their significant contribution to overall cCMV-related morbidity.

Purpose of the Study:

  • To review current evidence and controversies surrounding cCMV-related SNHL in asymptomatic or mildly symptomatic children.
  • To highlight the public health impact of delayed complications in asymptomatic cCMV cases.
  • To identify gaps in screening, diagnostic classification, and antiviral management for cCMV.

Main Methods:

  • Literature review synthesizing current evidence on cCMV.
  • Analysis of data on the incidence of late-onset hearing loss and neurodevelopmental abnormalities in asymptomatic infants.
  • Examination of existing screening protocols and treatment guidelines.

Main Results:

  • 8-15% of asymptomatic congenital CMV carriers develop late-onset hearing loss.
  • 5-10% of asymptomatic cases may exhibit neurodevelopmental abnormalities.
  • Delayed complications in asymptomatic infants account for 30-40% of all cCMV-related long-term morbidity.

Conclusions:

  • Asymptomatic congenital CMV is a significant, underrecognized cause of SNHL and neurodevelopmental deficits in children.
  • There is a critical need for heightened clinical awareness, improved screening, and standardized management protocols for asymptomatic cCMV.
  • Addressing management gaps for asymptomatic infants is essential to mitigate long-term health consequences and reduce public health burden.

Keywords:
antiviral therapycongenital cytomegalovirus infectiondelayed-onset hearing lossganciclovirsensorineural hearing lossuniversal screeningvalganciclovir

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