COMMENTARY

Congenital CMV and Hearing Loss: What's the Risk?

Tatiana Lanzieri, MD, MPH

Disclosures

June 12, 2017

Editorial Collaboration

Medscape &

Hello. I'm Dr Tatiana Lanzieri, a medical epidemiologist at CDC. I'm pleased to speak with you as part of the CDC Expert Commentary Series on Medscape. Today I'll discuss recent findings from a study on hearing loss among children with congenital cytomegalovirus (CMV) infection.

Hearing loss in children with congenital CMV can be present at birth or develop later. It is estimated that 15%-20% of all cases of moderate to profound hearing loss among children are attributable to congenital CMV.[1]

In the United States, about 20,000 infants are born with congenital CMV each year. About 90% of infected infants appear normal on their newborn exam, but around 15% of these infants develop hearing loss.[2] Our study assessed the risk for hearing loss among children with asymptomatic congenital CMV infection compared with uninfected children.[3]

This study included long-term follow-up of 92 infants with asymptomatic congenital CMV, identified by newborn urine screening at Women's Hospital of Texas in Houston from 1982 to 1992. For comparison, 51 uninfected infants were followed. All received regular hearing evaluations from birth up to age 18 years.

We found that children with asymptomatic congenital CMV:

  • Are about four times as likely to develop hearing loss than uninfected children;

  • Can have hearing loss that is progressive through adolescence; and

  • In 2% of these children, hearing loss will be severe enough for them to be candidates for cochlear implants by age 5 years.

The good news is that children with asymptomatic congenital CMV who have normal hearing up to age 5 years do not appear to be at higher risk of later developing hearing loss than uninfected children.

Most children with congenital CMV are not identified because currently there is no universal newborn screening for CMV. Antivirals such as ganciclovir and valganciclovir have been shown to benefit children with signs and symptoms of congenital CMV disease at birth. However, antiviral treatment for asymptomatic infants with only hearing loss has not yet been shown to be safe or effective in controlled studies.

All children should receive regular hearing evaluations. Children who are diagnosed with hearing loss should begin to receive treatment and support services as soon as possible. Early intervention helps young children with hearing loss learn language and other important development skills. Research shows that early intervention can greatly improve a child's development.

Thank you for watching.

Web Resource

CDC: CMV and Congenital CMV Infection

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