Abstract
Although earlier studies have shown that antiviral treatment regimens using valganciclovir (VGCV) improved hearing function in some infants with congenital cytomegalovirus (CMV) infection; its efficacy on the severity of hearing dysfunction is unclear. We conducted a prospective study among 26 infants with congenital CMV infections from 2009 to 2018. Oral VGCV (32 mg/kg/day) was administered for 6 weeks (November 2009 to June 2015; n = 20) or 6 months (July 2015 to March 2018, n = 6). Hearing function was evaluated by measuring the auditory brainstem response before VGCV treatment and at 6 months. Hearing dysfunction, defined as a V-wave threshold >40 dB, was categorized into: most severe, ≥91 dB; severe, 61–90 dB; and moderate, 41–60 dB. Hearing improvement was defined as a decrease of ≥20 dB from the pretreatment V-wave threshold. Of 52 ears in 26 infants with congenital CMV infection, 29 (56%) had hearing dysfunction, and of 29 ears, 16 (55%) improved after VGCV treatment. Although, 16 (84%) of 19 ears with moderate or severe hearing dysfunction improved after treatment (p < 0.001), 10 ears with the most severe form did not. In conclusion, VGCV treatment is effective in improving moderate and severe hearing dysfunction in infants with congenital CMV infection.
Highlights
Congenital sensorineural hearing loss can be caused by hereditary or non-hereditary factors
The use of antiviral therapies such as intravenous (IV) ganciclovir (GCV) or oral valganciclovir (VGCV) for congenital CMV infection, has garnered clinical interest in recent years because various reports have shown the effects of these therapies on the reversal of hearing loss or prevention of its deterioration [2,3,4,5]
2) Oral VGCV (34 mg/kg/day) for 12 weeks, and subsequent doses of 17 mg/kg/day until the age of 1. They observed that the likelihood of improvement of hearing loss post-treatment was inversely associated with its severity at baseline; with improvement observed in 78%, 68%, and 41% of ears with mild, moderate, and severe hearing dysfunction, respectively [5]
Summary
Congenital sensorineural hearing loss can be caused by hereditary or non-hereditary factors. The use of antiviral therapies such as intravenous (IV) ganciclovir (GCV) or oral valganciclovir (VGCV) for congenital CMV infection, has garnered clinical interest in recent years because various reports have shown the effects of these therapies on the reversal of hearing loss or prevention of its deterioration [2,3,4,5]. 2) Oral VGCV (34 mg/kg/day) for 12 weeks, and subsequent doses of 17 mg/kg/day until the age of 1 They observed that the likelihood of improvement of hearing loss post-treatment was inversely associated with its severity at baseline; with improvement observed in 78%, 68%, and 41% of ears with mild, moderate, and severe hearing dysfunction, respectively [5]. Whilst baseline hearing was consistently assessed at the same time across subjects, the exact timing of post-treatment assessments (at age ≥1 year) varied from child to child
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