Insight Into Long-term Neurodevelopmental Outcomes in Asymptomatic Congenital CMV Infection.

Abstract

* Abbreviations: cCMV — : congenital cytomegalovirus infection CMV — : cytomegalovirus SES — : socioeconomic status SNHL — : sensorineural hearing loss In this issue of Pediatrics , Lopez et al1 describe findings from a long-term follow-up study to determine the intellectual outcomes and academic performance of children with asymptomatic congenital cytomegalovirus infection (cCMV). cCMV is the most common congenital infection and is a leading nongenetic cause of sensorineural hearing loss (SNHL) and neurodevelopmental disability.2–4 In the United States, the number of infants who develop adverse hearing and neurodevelopmental outcomes from cCMV approaches those from Down syndrome and exceeds those from the fetal alcohol syndrome, spina bifida, and childhood infections (including HIV and Haemophilus influenzae type B meningitis before the vaccine era).5 Most infants (85%–90%) with cCMV have no detectable clinical abnormalities at birth (asymptomatic or subclinical cCMV), and ∼10% to 15% of these children have varying degrees of SNHL.3 Intellectual outcomes and academic performance in this group of children have not been well defined.6 This gap in our understanding is due to the fact that most asymptomatic infants are not recognized at birth. In addition, a retrospective diagnosis of cCMV is difficult because positive cytomegalovirus (CMV) results from specimens … Address correspondence to Suresh B. Boppana, MD, UAB Department of Pediatrics, University of Alabama School of Medicine, CHB 114, 1600 7th Ave South, Birmingham, AL 35233. E-mail: sboppana{at}peds.uab.edu