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Wednesday 8 June 2016
Clinical Predictors of Sensorineural Hearing Loss and Cognitive Outcome in Infants with Symptomatic Congenital Cytomegalovirus Infection

WAidid suggests an articlel on Symptomatic Congenital Cytomegalovirus in infants published on Pediatric Infectious Disease Journal in May. The objective of this study was to determine newborn clinical findings predictive of adverse clinical outcomes in infants with symptomatic congenital cytomegalovirus (cCMV) infection.

cCMV infection is a leading non-genetic cause of sensorineural hearing loss (SNHL) and neurologic disabilities in the U.S.. Of the 10-15% of infected infants with clinical evidence of congenital infection (symptomatic), 40-60% develop sequelae including SNHL, cerebral palsy, neurodevelopmental delay and retinitis. The risk factors for SNHL and other sequelae in children with cCMV are unknown. Identification of predictors of outcome will permit appropriate counseling, judicious resource utilization and selection of infants who would benefit most from anti-viral therapy. Since the presentation of symptomatic cCMV is highly variable, the authours explored whether symptomatic infants could be stratified for their risk of sequelae based on clinical presentation at birth. In this large cohort of children with symptomatic cCMV, we demonstrate that the risk of SNHL and adverse cognitive outcome varies depending on the clinical presentation at birth. The findings show that moderate to profound SNHL and poor cognitive outcome are more frequent in children with CNS involvement at birth. A possible explanation for higher incidence of SNHL and poor cognitive outcome in the CNS group is that the infection in early gestation leading to widespread virus dissemination in utero and more damage thereby increases the risk for adverse outcomes.

AUTHORS: Pinninti, Swetha G. MD; Rodgers, Mackenzie D. MD; Novak, Zdenek MD, PhD, MSHI; Britt, William J MD; Fowler, Karen B. DrPH; Boppana, Suresh B. MD; Ross, Shannon A. MD, MSPH