Congenital Cytomegalovirus Infection as a Cause of Sensorineural Hearing Loss in a Highly Immune Population

Autor(es)

Yamamoto, Aparecida Y. ^[1] ; Mussi-Pinhata, Marisa Marcia ^[1] ; Isaac, Myriam de Lima ^[2] ; Amaral, Fabiana R. ^[1] ; Carvalheiro, Cristina G. ^[1] ; Aragon, Davi C. ^[1] ; da Silva Manfredi, Alessandra K. ^[1] ; Boppana, Suresh B. ^{[3, 4]} ; Britt, William J. ^{[3, 4, 5]}

Afiliação do(s) autor(es)

^[1] Univ Sao Paulo, Dept Pediat, Fac Med Ribeirao Preto, BR-14049900 Sao Paulo - Brazil

^[2] Univ Sao Paulo, Dept Ophtalmol Otorrinolaringol & Head & Neck Sur, Fac Med Ribeirao Preto, BR-14049900 Sao Paulo - Brazil

^[3] Univ Alabama, Sch Med, Dept Pediat, Birmingham, AL - USA

^[4] Univ Alabama, Sch Med, Dept Microbiol, Birmingham, AL 35294 - USA

^[5] Univ Alabama, Sch Med, Dept Neurobiol, Birmingham, AL - USA

• Tipo de documento: Artigo Científico
• Fonte: PEDIATRIC INFECTIOUS DISEASE JOURNAL; v. 30, n. 12, p. 1043-1046, DEC 2011.
• Citações Web of Science: 67

Resumo

Background: The burden of congenital cytomegalovirus (CMV)-associated sensorineural hearing loss (SNHL) in populations with CMV seroprevalence approaching 100% is unknown. The purpose of this study was to assess the rate, associated factors, and predictors of SNHL in CMV-infected infants identified by newborn screening in a highly seropositive maternal population. Methods: Newborns with positive saliva CMV-DNA that was confirmed by virus isolation in the first 2 weeks of life were enrolled in a prospective follow-up study to monitor hearing outcome. Results: Of 12,195 infants screened, 121 (1%) were infected with CMV and 12 (10%) had symptomatic infection at birth. Hearing function could be assessed in 102/121 children who underwent at least one auditory brainstem evoked response testing at a median age of 12 months. SNHL was observed in 10/102 (9.8%; 95% confidence interval: 5.1-16.7) children. Median age at the latest hearing evaluation was 47 months (12-84 months). Profound loss (>90 dB) was found in 4/5 children with bilateral SNHL while all 5 children with unilateral loss had moderate to severe deficit. The presence of symptomatic infection at birth (odds ratio, 38.1; 95% confidence interval: 1.6-916.7) was independently associated with SNHL after adjusting for intrauterine growth restriction, gestational age, gravidity, and maternal age. Among 10 infants with SNHL, 6 (60%) were born to mothers with nonprimary CMV infection. Conclusions: Even in populations with near universal immunity to CMV, congenital CMV infection is a significant cause of SNHL demonstrating the importance of CMV as a major cause of SNHL in children worldwide. As in other populations, SNHL is more frequently observed in symptomatic CMV infection. (AU)

• Processo FAPESP: 02/04166-6 - Infecção congênita por citomegalovírus em população com elevada soropositividade: caracterização molecular das cepas virais e avaliação da ocorrência de reinfecção materna
• Beneficiário: Aparecida Yulie Yamamoto
• Modalidade de apoio: Auxílio à Pesquisa - Regular