Abstract：Objective To investigate the risk factors for hearing impairment induced by cytomegalovirus (CMV) infection in children. Methods One hundred and fifty-eight children diagnosed with CMV infection were enrolled as subjects. Based on the results of the brainstem auditory evoked potential (BAEP) test, patients were classified into normal hearing group (n=117; BAEP ≤35) and abnormal hearing group (n=41; BAEP >35). A retrospective analysis was performed on the general information, routine blood indices, liver function, copy number of CMV-DNA in urine and breast milk. The receiver operating characteristic (ROC) curve was used to predict the copy number of CMV-DNA resulting in abnormal BAEP. The Spearman rank correlation analysis was used to test the correlations of the copy number of CMV-DNA in urine with the degree of hearing impairment and platelet count. Results The incidence rates of platelet abnormality and abnormal liver function and the copy number of CMV-DNA in urine were significantly higher in the abnormal hearing group than in the normal hearing group (P6 per mL. The results of correlation analysis showed that the degree of hearing impairment was positively correlated with the copy number of CMV-DNA (r=0.382, Pr=-0.233, P=0.003). Conclusions An increased copy number of CMV-DNA in urine might be a risk factor for hearing impairment induced by CMV infection. Children are likely to have hearing impairment when the copy number of CMV-DNA reaches 1.415×106 per mL. The monitoring of hearing should be strengthened in CMV-infected children with a decreased platelet count.
Engman ML, Malm G, Engstrom L, et al. Congenital CMV infection: prevalence in newborns and the impact on hearing deficit[J]. Scand J Infect Dis, 2008, 40(11-12): 935-942.
[2]
Hagay ZJ, Biran G, Ornoy A, et al. Congenital cytomegalovirus infection: a long-standing problem still seeking a solution[J]. Am J Obstet Gynecol, 1996, 174(1 Pt 1): 241-245.
[3]
Dollard SC, Schleiss MR, Grosse SD. Public health and laboratory considerations regarding newborn screening for congenital cytomegalovirus[J]. J Inherit Metab Dis, 2010, 33(Suppl 2): S249-S254.
[4]
Grosse SD, Ross DS, Dollard SC. Congenital cytomegalovirus (CMV) infection as a cause of permanent bilateral hearing loss: a quantitative assessment[J]. J Clin Virol, 2008, 41(2): 57-62.
[5]
Ross SA, Novak Z, Fowler KB, et al. Cytomegalovirus blood viral load and hearing loss in young children with congenital infection[J]. Pediatr Infect Dis J, 2009, 28(7): 588-592.
[6]
Boppana SB, Fowler KB, Pass RF, et al. Congenital cytomegalovirus infection: association between virus burden in infancy and hearing loss[J]. J Pediatr, 2005, 146(6): 817-823.
Boppana SB, Ross SA, Fowler KB. Congenital cytomegalovirus infection: clinical outcome[J]. Clin Infect Dis, 2013, 57 Suppl 4: S178-S181.
[9]
Lipitz S, Hoffmann C, Feldman B, et al. Value of prenatal ultrasound and magnetic resonance imaging in assessment of congenital primary cytomegalovirus infection[J]. Ultrasound Obstet Gynecol, 2010, 36(6): 709-717.
[10]
Fowler KB, McCollister FP, Dahle AJ, et al. Progressive and fluctuating sensorineural hearing loss in children with asymptomatic congenital cytomegalovirus infection[J]. J Pe¬diatr, 1997, 130(4): 624-630.
[11]
Gabrielli L, Bonasoni MP, Santini D, et al. Human fetal inner ear involvement in congenital cytomegalovirus infection[J]. Acta Neuropathol Commun, 2013, 1: 63.
[12]
Lanari M, Lazzarotto T, Venturi V, et al. Neonatal cytomegalovirus blood load and risk of sequelae in symptomatic and asymptomatic congenitally infected newborns[J]. Pediatrics, 2006, 117(1): e76-e83.
[13]
Rivera LB, Boppana SB, Fowler KB, et al. Predictors of hearing loss in children with symptomatic congenital cytomegalovirus infection[J]. Pediatrics, 2002, 110(4): 762-767.
Harrison GJ. Current controversies in diagnosis, management, and prevention of congenital cytomegalovirus: updates for the pediatric practitioner[J]. Pediatr Ann, 2015, 44(5): e115-e125.
[16]
Stronati M, Lombardi G, Garofoli F, et al. Pharmacokinetics, pharmacodynamics and clinical use of valganciclovir in newborns with symptomatic congenital cytomegalovirus infection[J]. Curr Drug Metab, 2013, 14(2): 208-215.
[17]
Bate SL, Cannon MJ. A social marketing approach to building a behavioral intervention for congenital cytomegalovirus[J]. Health Promot Pract, 2011, 12(3): 349-360.
