Progressive, Long-Term Hearing Loss in Congenital CMV Disease After Ganciclovir Therapy

Abstract Background Long-term hearing outcomes among children with symptomatic congenital cytomegalovirus (CMV) disease who received 6-week ganciclovir therapy early in life are unknown. Methods Longitudinal study of 76 children with symptomatic congenital CMV disease, born 1983-2005, who were categ...

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Published in:Journal of the Pediatric Infectious Diseases Society 2022-01, Vol.11 (1), p.16-23
Main Authors: Lanzieri, Tatiana M, Caviness, Alison Chantal, Blum, Peggy, Demmler-Harrison, Gail
Format: Article
Language:English
Subjects:
Antiviral Agents - adverse effects
Child
Cytomegalovirus Infections - drug therapy
Cytomegalovirus Infections - epidemiology
Ganciclovir - therapeutic use
Hearing Loss - chemically induced
Hearing Loss - epidemiology
Humans
Infant
Longitudinal Studies
Original
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Summary:Abstract Background Long-term hearing outcomes among children with symptomatic congenital cytomegalovirus (CMV) disease who received 6-week ganciclovir therapy early in life are unknown. Methods Longitudinal study of 76 children with symptomatic congenital CMV disease, born 1983-2005, who were categorized into three groups: group A treated with ganciclovir; group B untreated who had microcephaly, chorioretinitis, or sensorineural hearing loss (SNHL; ≥25 dB) diagnosed in the first month of life (congenital); and group C untreated who did not meet criteria for group B. Results Patients in groups A (n = 17), B (n = 27), and C (n = 32) were followed to median age of 13, 11, and 13 years, respectively. In group A, patients received ganciclovir for median of 40 (range, 11-63) days; 7 (41%) had grade 3 or 4 neutropenia. Congenital SNHL was diagnosed in 11 (65%) patients in group A, 15 (56%) in group B, and none in group C. Early-onset SNHL was diagnosed between ages ≥1-12 months in an additional 4 (24%), 6 (22%), and 8 (25%) patients in groups A, B, and C, respectively. By the end of follow-up, 12 (71%), 16 (59%), and 7 (22%) of patients in groups A, B, and C, respectively, had severe (>70 dB) SNHL in the better-hearing ear. Conclusions In this study, most patients with symptomatic congenital CMV disease and congenital or early-onset SNHL eventually developed hearing loss severe enough to have been potential candidates for cochlear implantation, with or without 6-week ganciclovir therapy. Understanding long-term hearing outcomes of patients treated with 6-month oral valganciclovir (current standard of care) is needed. This study indicated that most patients with symptomatic congenital CMV and congenital or early-onset sensorineural hearing loss developed severe loss, with or without ganciclovir therapy.
ISSN:2048-7207
2048-7193
2048-7207
DOI:10.1093/jpids/piab095