Hearing outcome of infants with congenital cytomegalovirus and hearing impairment

Bilavsky, Efraim; Shahar-Nissan, Keren; Pardo, Joseph; Attias, Joseph; Amir, Jacob

doi:10.1136/archdischild-2015-309154

Cited by 67 publications

(79 citation statements)

References 12 publications

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“…If the initial target of a viral infection is the stria vascularis, then with early detection and diagnosis, perhaps, some treatment for recovery is possible. This notion that CMV infection involves an initial phase of strial damage and a loss of EP is consistent with reports that early intervention with anti-viral agents such as gan/ valganciclovir can improve hearing outcomes (e.g., Kimberlin et al 2003Kimberlin et al , 2015Bilavsky et al 2016).…”

Section: Discussionsupporting

confidence: 72%

Cytomegalovirus (CMV) Infection Causes Degeneration of Cochlear Vasculature and Hearing Loss in a Mouse Model

Carraro

Almishaal

Hillas

et al. 2016

JARO

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Cytomegalovirus (CMV) infection is one of the most common causes of congenital hearing loss in children. We have used a murine model of CMV infection to reveal functional and structural cochlear pathogenesis. The cerebral cortex of Balb/c mice (Mus musculus) was inoculated with 2000 pfu (plaque forming units) of murine CMV on postnatal day 3. At 6 weeks of age, cochlear function was monitored using auditory brainstem response (ABR) and distortion product otoacoustic emission (DPOAE) measures. Histological assessment of cochlear vasculature using a corrosion cast technique was made at 8 weeks. Vascular casts of mCMV-damaged cochleas, and those of untreated control animals, were examined using scanning electron microscopy. We find very large variations in the degree of vascular damage in animals given identical viral injections (2000 pfu). The primary lesion caused by CMV infection is to the stria vascularis and to the adjacent spiral limbus capillary network. Capillary beds of the spiral ligament are generally less affected. The initial vascular damage is found in the mid-apical turn and appears to progress to more basal cochlear regions. After viral migration to the inner ear, the stria vascularis is the primary affected structure. We suggest that initial auditory threshold losses may relate to the poor development or maintenance of the endocochlear potential caused by strial dysfunction. Our increased understanding of the pathogenesis of CMV-related hearing loss is important for defining methods for early detection and treatment.

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Section: Discussionsupporting

confidence: 72%

Cytomegalovirus (CMV) Infection Causes Degeneration of Cochlear Vasculature and Hearing Loss in a Mouse Model

Carraro

Almishaal

Hillas

et al. 2016

JARO

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“…Although no formal regulations exist, still, most hospitals perform routine screening for anti-CMV antibodies using the criteria mentioned earlier to establish a diagnosis [74,125,126]. Once the presence of CMV is established in the mother, congenital CMV is diagnosed either by pre-natal amniocentesis followed by culture or PCR, or by PCR or antigenemia assays in the urine of the infant [73,75,76,78,80,104,108,127].…”

Section: Laboratory Diagnosis Of CMV In the Mena Regionmentioning

confidence: 99%

“…Currently, PCR is commonly used in the MENA region for the diagnosis of CMV. It is used to test for congenital CMV in amniotic fluid or urine [73,75,76,78,80,104,108,127], to monitor CMV infection after transplant [41,62,[133][134][135][136], as well as end-organ testing when a specific organ is affected, such as HIV associated CMV retinitis [137].…”

Section: Laboratory Diagnosis Of CMV In the Mena Regionmentioning

confidence: 99%

The Current Status of Cytomegalovirus (CMV) Prevalence in the MENA Region: A Systematic Review

et al. 2019

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Human cytomegalovirus (CMV) is a highly prevalent herpesvirus worldwide. According to the Centers for Disease Control and Prevention (CDC) and the World Health Organization (WHO), CMV infects people of all ages, and by the age of five, approximately one-third of children in the United States are infected. Although the infection is generally asymptomatic, it can cause severe disease in immunocompromised patients, transplant and transfusion recipients, as well as newborn neonates. The objective of this study is to systematically review published literature on CMV in the MENA region to estimate its incidence in the region and describe its epidemiological and clinical significance. The literature was searched through four scientific databases: PubMed, Scopus, Science Direct, and Web of Science. A total of 72 studies from 11 countries satisfied the inclusion criteria, covering a period from 1988–2019. The CMV IgG seroprevalence ranged from 8.7%–99.2% (SD = 38.95%). CMV incidence in these countries ranged between 1.22% and 77% in transplant and transfusion recipients, with an increase in incidence with advanced age. However, the incidence rate was unclear for congenital CMV due to the variability of the reporting. This review highlights the need for more robust and well-designed studies to better estimate CMV incidence in the MENA region, standardize diagnostic criteria, and consider prophylactic and pre-emptive treatments to limit the morbidity and mortality of the disease.

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“…Among symptomatic newborns with congenital CMV infection, an estimated 45 to 58% will develop permanent sequelae, including hearing loss (35%), motor/cognitive deficits (43%) and vision impairment (6%) (Dollard et al, 2007;Goderis et al, 2014;Cannon et al, 2014;Bilavsky et al, 2016). In contrast, only approximately 10 to 15% of asymptomatic newborns will have permanent sequelae, predominantly hearing loss (Dollard et al, 2007;Goderis et al, 2014).…”

Section: Congenital CMV Infectionmentioning

confidence: 99%

Cytomegalovirus infection in pregnancy

Davis

King

Kourtis

2017

Birth Defects Research

119

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Cytomegalovirus (CMV) is a DNA herpesvirus that is common worldwide. The two known main sources of primary CMV infection during pregnancy are through sexual activity and contact with young children. Primary infection occurs in approximately 1 to 4% of pregnancies, and is mostly asymptomatic in immunocompetent adults. However, primary infection may manifest as a mild mononucleosis or flu-like syndrome with persistent fever and fatigue. CMV can be transmitted from mother-to-child in utero, intrapartum, or during breastfeeding. Intrauterine transmission can lead to congenital CMV infection, a leading cause of permanent hearing and vision loss and neurological disability among children. Congenital CMV transmission rates are as high as 50% in women who acquire primary CMV infection during pregnancy, and less than 2% in women with nonprimary infection. There is no licensed CMV vaccine. Good hygiene practices and avoiding intimate contact with young children (e.g., kissing on the mouth and sharing utensils) have been suggested as an approach to prevent maternal primary CMV infection during pregnancy, but remains an unproven method of reducing the risk of congenital CMV infection. Approximately 1 in 10 infants who acquire CMV in utero will have clinical signs at birth, and an additional 10 to 15% will go on to develop late-onset sequelae. Antiviral treatment prenatally and postnatally has not proven effective at preventing congenital or postnatal CMV infection, and is not recommended for routine clinical care. However, antiviral treatment when initiated in the first month of life for symptomatic congenital CMV infection is recommended for improved neurodevelopmental and audiologic outcomes. Birth Defects Research 109:336-346, 2017. © 2017 Wiley Periodicals, Inc.

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Hearing outcome of infants with congenital cytomegalovirus and hearing impairment

Abstract: 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.

Cited by 67 publications

References 12 publications

Cytomegalovirus (CMV) Infection Causes Degeneration of Cochlear Vasculature and Hearing Loss in a Mouse Model

Cytomegalovirus (CMV) Infection Causes Degeneration of Cochlear Vasculature and Hearing Loss in a Mouse Model

The Current Status of Cytomegalovirus (CMV) Prevalence in the MENA Region: A Systematic Review

Cytomegalovirus infection in pregnancy

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