title: Congenital Cytomegalovirus Infection and Permanent Hearing Loss in Rural North Indian Children.
abstract: Congenital cytomegalovirus infection (cCMV) is a leading nongenetic cause of permanent congenital or early-onset hearing loss (PCEHL). Although cCMV rates are high despite near-universal seroimmunity, the contribution of cCMV to PCEHL in the developing world is unclear.
  
  
  
  Neonates at a rural North Indian hospital were screened for cCMV by saliva polymerase chain reaction and hearing by distortion-product otoacoustic emission testing. Cytomegalovirus (CMV)-positive infants and those not passing newborn hearing screening (NHS) were evaluated by auditory brainstem response to confirm PCEHL. Infants with cCMV and those with PCEHL were tested for mutations within the GJB2 gene.
  
  
  
  Of the 1720 infants screened, 40 (2.3%) did not pass NHS and 20 (1.2%) were CMV positive. Auditory brainstem evoked response testing confirmed unilateral or bilateral PCEHL in 11 (0.64%) children who either did not pass NHS or CMV positive. PCEHL was 20-fold higher in neonates with cCMV (2/20, 10%) than those without (9/1700, 0.5%; P < 0.01). None of 11 infants with PCEHL had connexin 26 mutations.
  
  
  
  PCEHL incidence is high in India, with cCMV contributing significantly despite near-universal seroimmunity. Our findings also demonstrate the feasibility and the utility of simultaneous newborn screening for both cCMV and hearing loss in a resource-limited setting.
authors.affiliation: From the *Department of Microbiology, †Department of Otolaryngology, ‡Department of Center for Community Medicine, and §Department of Pediatrics, All India Institute of Medical Sciences, New Delhi, India; ¶Department of Pediatrics, ‖Department of Epidemiology, and **Department of Microbiology, University of Alabama at Birmingham, Birmingham, Alabama.
authors.forename: Lalit
authors.initials: L
authors.lastname: Dar
authors.forename: Divya
authors.initials: D
authors.lastname: Namdeo
authors.forename: Pankaj
authors.initials: P
authors.lastname: Kumar
authors.forename: Alok
authors.initials: A
authors.lastname: Thakar
authors.forename: Shashi
authors.initials: S
authors.lastname: Kant
authors.forename: Sanjay
authors.initials: S
authors.lastname: Rai
authors.forename: Pawan K
authors.initials: PK
authors.lastname: Singh
authors.forename: Madhulika
authors.initials: M
authors.lastname: Kabra
authors.forename: Karen B
authors.initials: KB
authors.lastname: Fowler
authors.forename: Suresh B
authors.initials: SB
authors.lastname: Boppana
mesh_terms: D000072259:Connexin 26; D017630:Connexins / Q000235:genetics; D003586:Cytomegalovirus Infections / Q000150:complications / Q000151:congenital / Q000175:diagnosis / Q000453:epidemiology; D016057:Evoked Potentials, Auditory, Brain Stem; D005260:Female; D034381:Hearing Loss / Q000821:virology*; D006801:Humans; D007194:India / Q000453:epidemiology; D007231:Infant, Newborn; D008297:Male; D015997:Neonatal Screening; D011446:Prospective Studies; D012424:Rural Population
chemical_list: D017630:Connexins; C000607042:GJB2 protein, human; D000072259:Connexin 26