Abstract
Cytomegalovirus (CMV) infection is the most important cause of mental retardation and sensorineural hearing loss. Antiviral treatment with valganciclovir, a relatively new but potential toxic oral drug, is recommended to prevent further hearing deterioration. In this retrospective cohort study we evaluated the relation between the dose of valganciclovir and the reduction of CMV viral load, as well as the toxicity. All neonates with gestational age
Highlights
Cytomegalovirus (CMV) is a consistent infection worldwide
Five out of 6 infants had clinical symptoms of CMV infection consisting of intra-uterine growth restriction, hepatosplenomegaly and pneumonitis, the other infant showed only lenticulostriate vasculopathy, a neurologic involvement established on cerebral ultrasound scans in combination with a very high viral urine load and a gestational age
During treatment 4 out of 6 infants were negative for CMV isolation in urine; the time interval between the start of valganciclovir and the moment CMV viral load dropped below detection level was 25 - 54 days
Summary
Cytomegalovirus (CMV) is a consistent infection worldwide. In adults it is an innocuous infection; in neonates it is an important cause of neonatal morbidity. Antiviral treatment is recommended in selective cases; several small studies support preventive treatment with intravenous administered ganciclovir for further hearing deteriorations. This treatment requires long term hospitalization and withholds a reliable risk of catheter-associated infection. A relatively new drug for the treatment of CMV infection in neonates is oral valganciclovir. Boppana et al [11] and Lanari et al [12] already demonstrated that a high viral load, as a reflection of high virus activity, is associated with neuro sensorineural hearing loss. Valganciclovir, has the risk of serious toxic side effects including thrombocytopenia and leukocytopenia, determining plasma levels are recommended [7]
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