Long-Term Outcomes in Children With Congenital Cytomegalovirus Infection

Area of Science:

• Pediatrics
• Infectious Diseases
• Audiology

Background:

• Congenital cytomegalovirus (cCMV) infection is a leading cause of non-genetic sensorineural hearing loss in children.
• Long-term auditory outcomes in cCMV-infected children, particularly those treated with antivirals, require further investigation.

Purpose of the Study:

• To evaluate the long-term effects of early antiviral therapy, specifically valganciclovir (VGCV), on auditory outcomes in children with cCMV infection.
• To assess hearing loss progression and age of onset in treated versus untreated cCMV patients.

Main Methods:

• A retrospective cohort study of 56 pediatric patients with cCMV infection.
• Comparison of audiological assessments between a VGCV-treated group (n=19) and an untreated group (n=37) over a minimum 2-year follow-up.
• Definition of significant hearing decline as ≥10 dB loss.

Main Results:

• While overall prevalence and severity of hearing loss did not differ significantly, the VGCV-treated group showed significantly less hearing deterioration (26% vs. 41%, p<0.01).
• The magnitude of hearing decline was substantially smaller in the treated group (35.0±13.8 dB) compared to the untreated group (67.4±19.2 dB, p<0.002).
• Hearing loss stabilized by age 3 in treated children, whereas untreated children experienced recurrent hearing deterioration.

Conclusions:

• Early VGCV treatment for cCMV infection may stabilize hearing and mitigate long-term auditory damage in children.
• Prompt intervention and consistent hearing surveillance are crucial for managing cCMV-related hearing loss, especially in untreated cases.