title: Viral load in children with congenital cytomegalovirus infection identified on newborn hearing screening.
abstract: BACKGROUND
  Congenital cytomegalovirus (CMV) infection is the most common non-genetic cause of sensorineural hearing loss (SNHL) in children. However, congenital SNHL without other clinical abnormalities is rarely diagnosed as CMV-related in early infancy.
  
  
  OBJECTIVE
  The aim of this study was to identify and treat patients with congenital CMV-related SNHL or CMV-related clinical abnormalities other than SNHL. The association between CMV load and SNHL was also evaluated.
  
  
  METHODS
  Newborns who had abnormal hearing screening results or other clinical abnormalities were screened for congenital CMV infection by PCR of saliva or urine specimens, and identified infected patients were treated with valganciclovir (VGCV) for 6 weeks. The CMV load of patients with or without SNHL was compared at regular intervals during as well as after VGCV treatment.
  
  
  RESULTS
  Of 127 infants with abnormal hearing screening results, and 31 infants with other clinical abnormalities, CMV infection was identified in 6 and 3 infants, respectively. After VGCV treatment, 1 case had improved hearing but the other 5 SNHL cases had little or no improvement. Among these 9 patients with or without SNHL at 1 year of age, there was no significant difference in CMV blood or urine load at diagnosis, but both were significantly higher in patients with SNHL during VGCV treatment.
  
  
  CONCLUSIONS
  Selective CMV screening of newborns having an abnormal hearing screening result would be a reasonable strategy for identification of symptomatic congenital CMV infection. Prolonged detection of CMV in blood could be a risk factor for SNHL.
authors.affiliation: Department of Pediatrics, Nagoya University Graduate School of Medicine, Nagoya, Japan.
authors.forename: Jun-ichi
authors.initials: J
authors.lastname: Kawada
authors.affiliation: Department of Pediatrics, Nagoya University Graduate School of Medicine, Nagoya, Japan.
authors.forename: Yuka
authors.initials: Y
authors.lastname: Torii
authors.affiliation: Department of Pediatrics, Nagoya University Graduate School of Medicine, Nagoya, Japan.
authors.forename: Yoshihiko
authors.initials: Y
authors.lastname: Kawano
authors.affiliation: Department of Pediatrics, Nagoya University Graduate School of Medicine, Nagoya, Japan.
authors.forename: Michio
authors.initials: M
authors.lastname: Suzuki
authors.affiliation: Department of Pediatrics, Nagoya University Graduate School of Medicine, Nagoya, Japan.
authors.forename: Yasuko
authors.initials: Y
authors.lastname: Kamiya
authors.affiliation: Department of Obstetrics and Genecology, Nagoya University Graduate School of Medicine,Nagoya, Japan.
authors.forename: Tomomi
authors.initials: T
authors.lastname: Kotani
authors.affiliation: Department of Obstetrics and Genecology, Nagoya University Graduate School of Medicine,Nagoya, Japan.
authors.forename: Fumitaka
authors.initials: F
authors.lastname: Kikkawa
authors.affiliation: Department of Virology, Nagoya University Graduate School of Medicine, Nagoya, Japan.
authors.forename: Hiroshi
authors.initials: H
authors.lastname: Kimura
authors.affiliation: Department of Pediatrics, Nagoya University Graduate School of Medicine, Nagoya, Japan. Electronic address: yoshi-i@med.nagoya-u.ac.jp.
authors.forename: Yoshinori
authors.initials: Y
authors.lastname: Ito
mesh_terms: D000998:Antiviral Agents / Q000627:therapeutic use; D003587:Cytomegalovirus / Q000235:genetics / Q000302:isolation & purification*; D003586:Cytomegalovirus Infections / Q000151:congenital* / Q000188:drug therapy / Q000821:virology*; D005260:Female; D015774:Ganciclovir / Q000008:administration & dosage / Q000031:analogs & derivatives / Q000627:therapeutic use; D006319:Hearing Loss, Sensorineural / Q000821:virology*; D006320:Hearing Tests; D006801:Humans; D007223:Infant; D007231:Infant, Newborn; D008297:Male; D060888:Real-Time Polymerase Chain Reaction; D012307:Risk Factors; D012463:Saliva / Q000821:virology; D014556:Urine / Q000821:virology; D000077562:Valganciclovir; D019562:Viral Load
chemical_list: D000998:Antiviral Agents; D000077562:Valganciclovir; D015774:Ganciclovir
keywords: Congenital cytomegalovirus infection; Sensorineural hearing loss; Valganciclovir; Viral load