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Pediatric Infectious Disease Journal:
doi: 10.1097/INF.0b013e318198c724
Original Studies

Cytomegalovirus Shedding and Delayed Sensorineural Hearing Loss: Results From Longitudinal Follow-up of Children With Congenital Infection

Rosenthal, Lauren Stancik MPH*; Fowler, Karen B. DrPH†; Boppana, Suresh B. MD†; Britt, William J. MD†; Pass, Robert F. MD†; Schmid, Scott D. PhD*; Stagno, Sergio MD†; Cannon, Michael J. PhD*

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Background: The pathogenesis of cytomegalovirus (CMV)-related hearing loss is not well understood.

Objective: To evaluate the relationship between persistent CMV shedding and delayed sensorineural hearing loss in children born with congenital CMV.

Methods: Serial audiologic assessments and CMV cultures of urine and saliva were performed on 580 children who had been diagnosed with congenital CMV infection.

Results: Prevalence of CMV culture-positivity in any specimen decreased to approximately 50% by the third birthday and approximately 5% after the seventh birthday. Intermittent shedding occurred in 28% of children. Seventy-seven children had hearing loss at birth and 38 children developed delayed hearing loss by the end of follow-up. In multivariate analyses, delayed hearing loss was strongly associated with symptomatic infection at birth (OR = 5.9, 95% CI: 1.8–18.9) and modestly associated with older age at last culture-positive visit (OR = 1.6, 95% CI: 1.1–2.0, comparing 1-year age differences) Observed rates of delayed hearing loss were 0.79 per 100 person-years for children asymptomatic at birth and 4.29 per 100 person-years for children symptomatic at birth. Between the ages of 6 months and 8 years, we would expect delayed hearing loss to occur in 6.9% of asymptomatic children and in 33.7% of symptomatic children.

Conclusions: The strongest risk factor for delayed hearing loss was CMV-related symptoms at birth, but many asymptomatic children also developed delayed hearing loss. Longer duration of CMV shedding may also be a predictor of delayed hearing loss.

© 2009 Lippincott Williams & Wilkins, Inc.


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