Change in Viral Load during Antiviral Therapy Is Not Useful for the Prediction of Hearing Dysfunction in Symptomatic Congenital Cytomegalovirus Infection.

Shinya Abe,Kenji Tanimura,Shutaro Suga,Yuki Kyono,Kandai Nozu,Ruka Nakasone,Takumi Kido,Mariko Ashina,Kazumichi Fujioka,Hisayuki Matsumoto

doi:10.3390/jcm10245864

Abstract

For symptomatic congenital cytomegalovirus infections (CCMVI), the usefulness of changes in viral load during valganciclovir (VGCV) treatment for the prediction of hearing dysfunction (HD) is unclear. To determine the utility of viral load change in the whole blood or urine for the prediction of HD, we performed a retrospective study to compare viral load changes during VGCV treatment between CCMVI infants with (n = 12) or without (n = 8) HD at six months of corrected age, whose blood and urine viral loads were measured continuously for eight weeks from April 2009 to December 2019. There was no significant difference in the changes in both the blood and urine viral loads after the initiation of VGCV treatment between CCMVI infants between the groups. Moreover, this negative result was maintained in the analysis for each six weeks or six months treatment period. In conclusion, the change in viral load during antiviral therapy is not useful for the prediction of HD at six months of corrected age in symptomatic CCMVI.

Highlights

Congenital cytomegalovirus infection (CCMVI) is a disease that occurs when a mother experiences CMV infection during pregnancy, leading to vertical transmission to the fetus, and is the main etiology of congenital central nervous system disorders in developed countries
Regarding treatment responsiveness of CCMVI, we have revealed that the most severe hearing dysfunction did not improve after VGCV treatment, moderate or severe hearing dysfunction improved [5]
CCMVI infants treated with oral VGCV treatment during a 10-year study period (April 2009 to December 2019), whose blood and urine viral loads were measured continuously for 8 weeks

Summary

Introduction

Congenital cytomegalovirus infection (CCMVI) is a disease that occurs when a mother experiences CMV infection during pregnancy, leading to vertical transmission to the fetus, and is the main etiology of congenital central nervous system disorders in developed countries. For long-term outcomes, approximately 70–90% of infants with symptomatic CCMVI, which is accompanied by any clinical symptoms at birth, develop neurological sequelae, including hearing dysfunction, chorioretinitis, neuromuscular disorders (epilepsy, hemiplegia, and convulsions), psychomotor impairment, and intellectual disability. Antiviral therapies such as intravenous ganciclovir (GCV) and oral valganciclovir (VGCV), which have been reported to improve the prognosis, have been widely investigated [2,3]. Regarding treatment responsiveness of CCMVI, we have revealed that the most severe hearing dysfunction did not improve after VGCV treatment, moderate or severe hearing

Methods

Results

Conclusion