Antiviral Therapy Effective in Infants with Hearing Loss and CMV | Pediatrics

Publication

Key Points

  • 89% of untreated infants with congenital cytomegalovirus (cCMV) infection and isolated sensorineural hearing loss (SNHL) develop significant bilateral hearing loss
  • In valganciclovir treated cohort, only 35% of cCMV w/ isolated SHNL had functional hearing loss after 4-5y
  • No deterioration of unaffected ears observed in treated cohort

Background

  • CMV is most prevalent congenital infection (1/100 births globally)
  • Most common cause of pediatric SNHL
  • 2015 study demonstrated modest improvement in hearing outcomes for valganciclovir-treated symptomatic cCMV patients (most had symptom constellations other than isolated SHNL)
  • Most common adverse effect associated with valganciclovir in this study was neutropenia
  • Current guidelines recommend not treating cCMV infection with isolated SNHL

Methodology

  • Observational, retrospective cohort
  • 48 infants with congenital CMV and isolated SHNL loss who received prolonged valganciclovir therapy between 2005 and 2017
  • Treatment regimen: IV ganciclovir 5 mg/kg QD x 6w, then valganciclovir PO 17 mg/kg BID x6w, then QD until completion of 12 months of treatment; or valganciclovir 17 mg/kg PO BID for 12 weeks, then QID until completion of 12 months of treatment.
  • Primary endpoint: Hearing status (median follow-up 4-5y)

 

Source: Valganciclovir Is Beneficial in Children with Congenital Cytomegalovirus and Isolated Hearing Loss

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