Hearing Loss in Children With Asymptomatic Congenital Cytomegalovirus Infection

• Published in: Pediatrics (Evanston) 2017-03, Vol.139 (3), p.1-1
• Main Authors: Lanzieri, Tatiana M, Chung, Winnie, Flores, Marily, Blum, Peggy, Caviness, A Chantal, Bialek, Stephanie R, Grosse, Scott D, Miller, Jerry A, Demmler-Harrison, Gail
• Format: Article
• Language: English
• Subjects: Adolescent; Age of Onset; Asymptomatic Infections - epidemiology; Case-Control Studies; Child; Child, Preschool; Children; Children & youth; Cytomegalovirus; Cytomegalovirus infections; Cytomegalovirus Infections - congenital; Cytomegalovirus Infections - diagnosis; Cytomegalovirus Infections - epidemiology; Deafness; Deafness - epidemiology; Deafness - virology; Disease Progression; Evoked Potentials, Auditory, Brain Stem; Female; Hearing loss; Hearing Loss, Sensorineural - diagnosis; Hearing Loss, Sensorineural - epidemiology; Hearing Loss, Sensorineural - virology; Herpesviridae; Humans; Infant; Infant, Newborn; Male; Medical screening; Neonatal Screening; Pediatrics; Physiological aspects; Prevalence; Proportional Hazards Models; Severity of Illness Index; Survival analysis; Texas - epidemiology
• ISSN: 0031-4005; 1098-4275
• DOI: 10.1542/peds.2016-2610

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. 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. 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; = .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; = .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; < .01). The prevalence of severe to profound bilateral SNHL among case-patients was 2% (95% CI: 1%-9%). 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.