title: Hearing outcome of infants with congenital cytomegalovirus and hearing impairment.
abstract: BACKGROUND
  Congenital cytomegalovirus (cCMV) is the most common non-genetic cause of childhood sensorineural hearing loss. Antiviral treatment has been shown to prevent hearing deterioration in these infants. However, studies focused on infants with hearing impairment at birth and on the specific degree of impairment and further improvement or deterioration are lacking.
  
  
  OBJECTIVE
  To investigate the relationship between hearing status at birth and any change in hearing status at the end of a prolonged follow-up period, after receiving 12 months of antiviral treatment in children born with hearing impairment due to congenital cCMV.
  
  
  METHODS
  Clinical, laboratory, radiological and audiological data of all infants with cCMV infection followed in our centre between 2005 and 2013 were reviewed. Treatment with antiviral medication for hearing impairment found during the neonatal period was12 months of gan/valganciclovir. Hearing studies were performed only on infants who had been followed up for more than 1 year after treatment.
  
  
  RESULTS
  Hearing impairment at birth was found in 54 (36.2%) of the 149 infants diagnosed with symptomatic cCMV, and found in 77 affected ears; unilateral in 31 (57.4%) and bilateral in 23 (42.6%). After 1 year of antiviral treatment and a long-term follow-up of the 77 affected ears at baseline, 50 (64.9%) had improved, 22 (28.6%) remained unchanged and 5 (6.5%) had deteriorated. Most improved ears (38/50=76%) returned to normal hearing. Improvement was most likely to occur in infants born with mild or moderate hearing loss and less in those with severe impairment.
  
  
  CONCLUSIONS
  We found that infants born with cCMV and hearing impairment, receiving 12 months of antiviral treatment, showed significant improvement in hearing status. The probability of hearing improvement seems inversely related to the severity of the impairment at birth.
authors.affiliation: Department of Pediatrics C, Schneider Children's Medical Center, Petah Tiqva, Israel Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel.
authors.forename: Efraim
authors.initials: E
authors.lastname: Bilavsky
authors.affiliation: Department of Pediatrics C, Schneider Children's Medical Center, Petah Tiqva, Israel Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel.
authors.forename: Keren
authors.initials: K
authors.lastname: Shahar-Nissan
authors.affiliation: Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel Department of Gynecology and Obstetrics, Rabin Medical Center, Beilinson Hospital, Petah Tiqva, Israel.
authors.forename: Joseph
authors.initials: J
authors.lastname: Pardo
authors.affiliation: Institute of Audiology and Clinical Neurophysiology, Schneider Children's Medical Center, Petah Tiqva, Israel Department of Communication Sciences & Disorders, University of Haifa, Haifa, Israel.
authors.forename: Joseph
authors.initials: J
authors.lastname: Attias
authors.affiliation: Department of Pediatrics C, Schneider Children's Medical Center, Petah Tiqva, Israel Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel.
authors.forename: Jacob
authors.initials: J
authors.lastname: Amir
mesh_terms: D000998:Antiviral Agents / Q000627:therapeutic use*; D002648:Child; D003587:Cytomegalovirus; D003586:Cytomegalovirus Infections / Q000151:congenital / Q000188:drug therapy / Q000503:physiopathology*; D005260:Female; D005500:Follow-Up Studies; D015774:Ganciclovir / Q000031:analogs & derivatives* / Q000627:therapeutic use; D006309:Hearing / Q000502:physiology*; D006319:Hearing Loss, Sensorineural / Q000151:congenital / Q000188:drug therapy / Q000503:physiopathology*; D006320:Hearing Tests; D006801:Humans; D007223:Infant; D007557:Israel; D008297:Male; D012189:Retrospective Studies; D000077562:Valganciclovir
chemical_list: D000998:Antiviral Agents; D000077562:Valganciclovir; D015774:Ganciclovir
keywords: Audiology; Congenital Abnorm