Contribution of Congenital Cytomegalovirus Infection to Permanent Hearing Loss in a Highly Seropositive Population: The Brazilian Cytomegalovirus Hearing and Maternal Secondary Infection Study.
Contribution of Congenital Cytomegalovirus Infection to Permanent Hearing Loss in a Highly Seropositive Population: The Brazilian Cytomegalovirus Hearing and Maternal Secondary Infection Study.
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先天性巨细胞病毒感染对高度血清阳性人群永久性听力损失的影响：巴西巨细胞病毒听力和孕产妇继发感染研究。
DOI：
10.1093/cid/ciz413
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发表时间：
2020
期刊：
影响因子：
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通讯作者：
Mussi-Pinhata,MarisaM
中科院分区：
文献类型：
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作者：
Yamamoto,AparecidaY;Anastasio,AdrianaRT;Massuda,EduardoT;Isaac,MyriamL;Manfredi,AlessandraKS;Cavalcante,JulianaMS;Carnevale-Silva,Adriana;Fowler,KarenB;Boppana,SureshB;Britt,WilliamJ;Mussi-Pinhata,MarisaM
背景先天性巨细胞病毒感染（cCMVI）在高血清阳性人群中对永久性听力损失（HL）的确切贡献尚不清楚。我们确定了cCMVI对HL的贡献，并估计了新生儿听力筛查（HS）在识别cmv相关HL的新生儿中的有效性。方法对1 900例孕产妇血清阳性率≥97%的新生儿进行cCMVI和HL筛查。年龄<3周龄时通过唾液和尿液CMV-DNA检测证实cCMVI。结果共有68例（0.6%；95%可信区间[CI]， 0.4-0.7）新生儿被确诊为cCMVI。在91例（0.8%）HS未通过的新生儿中，24例（26.4%）确诊为HL，其中7例（29.2%;95% CI, 17.2-59.3）为cCMVI。另一名患有cCMVI的新生儿通过了HS，但在21天时被证实患有HL。在接受完整听力评估的62例cCMVI新生儿中，8例（12.9%;95% CI, 6.7-23.4）为HL，大多数（7/8;87.5%;95% CI, 46.6-99.7）为HS。巨细胞病毒相关的HL发病率为每11887名新生儿中有8例（每1000名活产婴儿中有0.7例）。与未感染cmv的新生儿相比，患有cCMVI的新生儿中HL的患病率为89.5 （95% CI, 39.7-202.0）。在中位随访36个月期间，未发现迟发性ccmvi相关HL。结论cmvi是儿童HL发病的重要原因。在HS失败的新生儿中整合有针对性的cCMVI筛查可能是一种合理且具有成本效益的策略，可以识别早发性cCMVI相关HL的新生儿。
BackgroundThe exact contribution of congenital cytomegalovirus infection (cCMVI) to permanent hearing loss (HL) in highly seropositive populations is unknown. We determined the contribution of cCMVI to HL and estimated the effectiveness of newborn hearing screening (HS) in identifying neonates with CMV-related HL.MethodsA total of 11 900 neonates born from a population with ≥97% maternal seroprevalence were screened for cCMVI and HL. cCMVI was confirmed by detection of CMV-DNA in saliva and urine at age <3 weeks.ResultsOverall, 68 (0.6%; 95% confidence interval [CI], 0.4–0.7) neonates were identified with cCMVI. Of the 91 (0.8%) newborns who failed the HS, 24 (26.4%) were confirmed with HL, including 7 (29.2%; 95% CI, 17.2–59.3) with cCMVI. Another newborn with cCMVI passed the HS but was confirmed with HL at age 21 days. Of the 62 neonates with cCMVI who underwent a complete hearing evaluation, 8 (12.9%; 95% CI, 6.7–23.4) had HL and most (7/8; 87.5%; 95% CI, 46.6–99.7) were identified by HS. The rate of CMV-related HL was 8 per 11 887 neonates (0.7 per 1000 live births). The prevalence ratio of HL among neonates with cCMVI compared to CMV-uninfected neonates was 89.5 (95% CI, 39.7–202.0). No late-onset cCMVI-related HL was detected during a median follow-up of 36 months.ConclusionscCMVI is an important cause of HL in childhood in all settings. Integrating targeted cCMVI screening among neonates who fail a HS could be a reasonable, cost-effective strategy to identify newborns with early-onset cCMVI-related HL.