The prevalence and demographic features of congenital cytomegalovirus infection in an urban area of East Asia: A population-based study.

Tzong-Hann Yang,Tien-Chen Liu,Wei-Chung Hsu,Li-Min Huang,Po-Nien Tsao,Chuan-Jen Hsu,Chuan-Song Wu,Shih-Ming Weng,Chen-Chi Wu,Hung-Meng Huang,Chun-Yi Lu,Kazumichi Fujioka

doi:10.1371/journal.pone.0248801

Abstract

Congenital cytomegalovirus (cCMV) infection is the leading environmental cause of childhood hearing impairment. However, its significance remains largely undocumented in many regions of the world. The purpose of this study was to investigate the prevalence and clinical features of cCMV infection in East Asia. Neonates born at a municipal hospital in Taipei were prospectively recruited and underwent concurrent hearing and CMV screenings. Those who failed the hearing screening or screened positive for CMV were subjected to a focused audiological and/or virological surveillance. The characteristics of the newborns and their mothers were compared between the CMV-positive and CMV-negative groups. Of the 1,532 newborns who underwent concurrent hearing and CMV screenings, seven (0.46%) were positive for cCMV infection. All seven CMV-positive newborns were asymptomatic at birth, and none of them developed hearing or other symptoms during a follow-up period of 14.4±6.3 months. The mothers of the CMV-positive newborns demonstrated higher gravidity (2.4 ± 1.4 vs. 2.1 ± 1.2) and parity (2.0 ± 1.2 vs. 1.6 ± 0.7) than those in the CMV-negative group; however, the difference did not reach statistical significance. The prevalence of cCMV infection in Taipei newborns was 0.46%, which is slightly lower than that of other populations and that of a previous report in the Taiwanese population. The relatively low prevalence in this study might be attributed to the improved public health system and decreased fertility rate in Taiwan.

Highlights

Sensorineural hearing loss (SNHL) is a common clinical entity in newborns [1,2] and children [3,4]
The importance of identifying congenital cytomegalovirus (cCMV) infection as the etiology of SNHL in newborns has become clinically relevant with the availability of oral antiviral agents that may prevent the progression of cCMV-related SNHL [19]
We aimed to investigate the prevalence of cCMV infection in newborns from an urban region of East Asia and the clinical characteristics of cCMV-positive children and their mothers

Summary

Introduction

Sensorineural hearing loss (SNHL) is a common clinical entity in newborns [1,2] and children [3,4]. The clinical significance and contribution of the environmental factors that might lead to pediatric SNHL in these children largely remains unclear [8,11,12,15,16]. Among these environmental factors, congenital cytomegalovirus (cCMV) infection is the leading cause of pediatric SNHL [17] and neurodevelopmental disability [18] in developed countries. Children with cCMV infection are at risk for progressive SNHL that may not be present until several years of age, at a time when the golden period for hearing-loss rehabilitation has passed [20,21,22]

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