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. 2017 Mar;139(3):e20162610.
doi: 10.1542/peds.2016-2610. Epub 2017 Feb 16.

Hearing Loss in Children With Asymptomatic Congenital Cytomegalovirus Infection

Tatiana M Lanzieri  1 , Winnie Chung  2 , Marily Flores  3 , Peggy Blum  4 , A Chantal Caviness  3 , Stephanie R Bialek  5 , Scott D Grosse  2 , Jerry A Miller  3   6 , Gail Demmler-Harrison  3   4 ; Congenital Cytomegalovirus Longitudinal Study Group
Affiliations

Hearing Loss in Children With Asymptomatic Congenital Cytomegalovirus Infection

Tatiana M Lanzieri et al. Pediatrics. 2017 Mar.

Abstract

Objectives: To assess the prevalence, characteristics, and risk of sensorineural hearing loss (SNHL) in children with congenital cytomegalovirus infection identified through hospital-based newborn screening who were asymptomatic at birth compared with uninfected children.

Methods: We included 92 case-patients and 51 controls assessed by using auditory brainstem response and behavioral audiometry. We used Kaplan-Meier survival analysis to estimate the prevalence of SNHL, defined as ≥25 dB hearing level at any frequency and Cox proportional hazards regression analyses to compare SNHL risk between groups.

Results: At age 18 years, SNHL prevalence was 25% (95% confidence interval [CI]: 17%-36%) among case-patients and 8% (95% CI: 3%-22%) in controls (hazard ratio [HR]: 4.0; 95% CI: 1.2-14.5; P = .02). Among children without SNHL by age 5 years, the risk of delayed-onset SNHL was not significantly greater for case-patients than for controls (HR: 1.6; 95% CI: 0.4-6.1; P = .5). Among case-patients, the risk of delayed-onset SNHL was significantly greater among those with unilateral congenital/early-onset hearing loss than those without (HR: 6.9; 95% CI: 2.5-19.1; P < .01). The prevalence of severe to profound bilateral SNHL among case-patients was 2% (95% CI: 1%-9%).

Conclusions: Delayed-onset and progression of SNHL among children with asymptomatic congenital cytomegalovirus infection continued to occur throughout adolescence. However, the risk of developing SNHL after age 5 years among case-patients was not different than in uninfected children. Overall, 2% of case-patients developed SNHL that was severe enough for them to be candidates for cochlear implantation.

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Conflict of interest statement

POTENTIAL CONFLICT OF INTEREST: Dr Demmler-Harrison’s institution has received funding from Merck Sharpe & Dohme Corporation since July 2016 to assist with salary support for additional analysis on the long-term outcomes of congenital cytomegalovirus infection not included in this report. The other authors have indicated they have no potential conflicts of interest to disclose.

Figures

FIGURE 1
FIGURE 1
SNHL among children with asymptomatic congenital CMV infection and controls.
FIGURE 2
FIGURE 2
Delayed-onset SNHL among children with asymptomatic congenital CMV infection with and without unilateral congenital/early-onset hearing loss.
FIGURE 3
FIGURE 3
Cumulative number of children with asymptomatic congenital CMV infection with SNHL (n = 20) by age and SNHL severity in the poorer- (A) and better-hearing (B) ears.
See this image and copyright information in PMC

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