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A wider role for congenital cytomegalovirus infection in sensorineural hearing loss

BARBI, MARIA DSC; BINDA, SANDRO BSC, PhD; CAROPPO, SIMONA BSC, PhD; AMBROSETTI, UMBERTO MD; CORBETTA, CARLO MD; SERGI, PAOLA MD

The Pediatric Infectious Disease Journal: January 2003 - Volume 22 - Issue 1 - p 39-42
Original Studies

Background. Diagnostic problems in identifying congenital infection cases in infancy have thus far impaired the assessment of the role of congenital cytomegalovirus (CMV) infection in the etiology of sensorineural hearing loss (SNHL).

Objective. To estimate the impact of congenital infection in children with SNHL by detection of CMV DNA in stored samples of neonatal dried blood (dried blood spots test).

Methods. The Guthrie cards of 130 children with hearing loss >40 dB hearing loss were retrieved from the regional screening center. CMV DNA was extracted by thermal shock and amplified by PCR.

Results. The percentage of SNHL cases attributable to congenital CMV infection was 10% (9 of 87) in infants whose SNHL had been diagnosed in their first 2 months of life and 34.2% (13 of 38) in children with deafness of unidentified cause that was diagnosed in early childhood. In the latter group 42.7% (12 of 28) of the children with a hearing loss of >70 dB were CMV-positive.

Conclusions. The results suggest that congenital CMV infection has a more relevant role in the etiology of SNHL than previously reported. The data obtained in both groups suggest that 20 to 30% of all deafness cases are caused by CMV. The percent of congenital CMV cases alone appears to account for all the cases previously attributed to all congenital infections. More than 40% of deafness cases with an unknown cause, needing rehabilitation, are caused by congenital CMV.

From Istituto di Virologia (MB, SB, SC) and Dipartimento di Scienze Otorinolaringologiche (UA), Università di Milano; and Laboratorio di Ricerche Cliniche (CC) and Unità Operativa Neurologia-Neurofisiopatologia (PS), Istituti Clinici di Perfezionamento, Milan, Italy.

Accepted for publication Oct. 1, 2002.

Address for reprints: Maria Barbi, Istituto di Virologia, Via Pascal 38, 20133 Milan, Italy. Fax 39 02 50315120; E-mail maria.barbi@unimi.it.

© 2003 Lippincott Williams & Wilkins, Inc.