Congenital cytomegalovirus infection from the viewpoint of otorhinolaryngologist
Authors:
Ugorová D. 1; Polakovičová Z. 2; Dobišová I. 2; Pejhovská L. 2; Chovancová D. 2; Profant M. 1; Varga L. 1
Authors‘ workplace:
Klinika otorinolaryngológie a chirurgie hlavy a krku LF UK a UN Bratislava
1; Novorodenecká klinika M. Rusnáka SZU a UN Bratislava
2
Published in:
Otorinolaryngol Foniatr, 71, 2022, No. 4, pp. 210-217.
Category:
Review Article
doi:
https://doi.org/10.48095/ccorl2022210
Overview
Congenital cytomegalovirus infection (cCMV) is the most common non-genetic cause of congenital sensorineural hearing loss (SNHL) and one of the most prevalent inborn infections. Its symptoms are variable, from thrombocytopenia to neurodevelopmental defects. Long-term consequences, including SNHL, occur in about 15% of newborns. However, they are often born asymptomatic and the SNHL develops later in childhood, leading to a high number of undiagnosed cases. Available diagnostic methods vary in their reliability and require correct indication and subsequent interpretation of the results. A different approach represents the implementation of full-scale cCMV screening into the current neonatal screening programs. The goal of our review article is to summarize the currently available data about congenital CMV infection associated with hearing loss with particular emphasis on recent diagnostic strategies.
Keywords:
hearing loss – screening – newborn – cytomegalovirus
Sources
1. Manicklal S, Emery VC, Lazzarotto T et al. The “silent” global burden of congenital cytomegalovirus. Clin Microbiol Rev 2013; 26 (1): 86–102. Doi: 10.1128/CMR.00062-12.
2. Boeckh M, Geballe AP. Cytomegalovirus: pathogen, paradigm, and puzzle. J Clin Invest 2011; 121 (5): 1673–1680. Doi: 10.1172/JCI45 449.
3. Balmer E. NHSGGC Guidelines: cytomegalovirus (CMV) – congenital infection. 2022 [online]. Dostupné z URL: https: //www.clinicalguidelines.scot.nhs.uk/nhsggc-guidelines/nhsggc-guidelines/neonatology/cytomegalovirus-cmv-congenital-infection/.
4. Gantt S, Dionne F, Kozak FK et al. Cost-effectiveness of universal and targeted newborn screening for congenital cytomegalovirus infection. JAMA Pediatr 2016; 170 (12): 1173–80. Doi: 10.1001/jamapediatrics.2016.2016.
5. Rawlinson WD, Palasanthiran P, Hall B et al. Neonates with congenital cytomegalovirus and hearing loss identified via the universal newborn hearing screening program. J Clin Virol 2018; 102: 110–15. Doi: 10.1016/j.jcv.2018.03. 006.
6. Rawlinson WD, Boppana SB, Fowler KB et al. Congenital cytomegalovirus infection in pregnancy and the neonate: consensus recommendations for prevention, diagnosis, and therapy. Lancet Infect Dis 2017; 17 (6): 177–188. Doi: 10.1016/S1473-3099 (17) 30143-3.
7. Lanzieri TM, Kruszon-Moran D, Gambhir M et al. Influence of parity and sexual history on cytomegalovirus seroprevalence among women aged 20–49 years in the USA. Suppl Int J Gynecol Obstet 2016; 135 (1): 82–85. Doi: 10.1016/j.ijgo.2016.03.032.
8. Halwachs-Baumann G, Genser B, Danda M et al. Screening and diagnosis of congenital cytomegalovirus infection: a 5-y study. Scand J Infect Dis 2000; 32: 137–142. Doi: 10.1080/003655400750045222.
9. Barbi M, Binda S, Caroppo S et al. Multicity Italian study of congenital cytomegalovirus infection. Pediatr Infect Dis J. 2006; 25 (2): 156–159. Doi: 10.1097/01.inf.0000199261.98769.29.
10. Numazaki K, Fujikama T. Chronological changes of incidence and prognosis of children with asymptomatic congenital cytomegalovirus infection in Sapporo, Japan. BMC Infect Dis 2004; 4 (1): 1–5. Doi: 10.1186/1471-2334- -4-22.
11. Yinon Y, Yagel S, Tepperberg-Dikawa M et al. Prenatal diagnosis and outcome of congenital cytomegalovirus infection in twin pregnancies. BJOG 2006; 113 (3): 295–300. Doi: 10.1111/j.1471-0528.2006.00854.x.
12. Kenneson A, Cannon MJ. Review and meta-analysis of the epidemiology of congenital cytomegalovirus (CMV) infection. Rev Med Virol 2007; 17 (4): 253–276. Doi: 10.1002/rmv. 535.
13. Goderis J, Leenheer E de, Smets K et al. Hearing loss and congenital CMV infection: A systematic review. Pediatrics 2014; 134 (5): 972–982. Doi: 10.1542/peds.2014-1173.
14. Gantt S, Bitnun A, Renaud C et al. Diagnosis and management of infants with congenital cytomegalovirus infection. Paediatr Child Health 2017; 22 (2): 72–74. Doi: 10.1093/pch/pxx 002.
15. Zheng QY, Huynh KT, Zuylen WJ et al. Cytomegalovirus infection in day care centres: A systematic review and meta-analysis of prevalence of infection in children. Rev Med Virol 2019; 29 (1): 2011. Doi: 10.1002/rmv.2011.
16. Dobbie AM. Evaluation and management of cytomegalovirus-associated congenital hearing loss. Curr Opin Otolaryngol Head Neck Surg 2017; 25 (5): 390–395. Doi: 10.1097/MOO.0000 000000000401.
17. Enders G, Daiminger A, Bäder U et al. Intrauterine transmission and clinical outcome of 248 pregnancies with primary cytomegalovirus infection in relation to gestational age. J Clin Virol 2011; 52 (3): 244–46. Doi: 10.1016/j.jcv.2011.07.005.
18. Bodéus M, Benoit KM, Zech F et al. Human cytomegalovirus in utero transmission: follow-up of 524 maternal seroconversions. J Clin Virol 2010; 47 (2): 201–202. Doi: 10.1016/j.jcv.2009.11.009.
19. Bodéus M, Hubinont C, Goubau P. Increased risk of cytomegalovirus transmission in utero during late gestation. Obstet Gynecol 1999; 93 (5 Pt 1): 658–660. Doi: 10.1016/S0029- 7844 (98) 00538-9.
20. Wang C, Zhang X, Bialek S et al. Attribution of congenital cytomegalovirus infection to primary versus non-primary maternal infection. Clin Infect Dis 2011; 52 (2): 11–13. Doi: 10.1093/cid/ciq085.
21. Dollard SC, Grosse SD, Ross DS. New estimates of the prevalence of neurological and sensory sequelae and mortality associated with congenital cytomegalovirus infection. Rev in Med Virol 2007; 17 (5): 355–363. Doi: 10.1002/r mv.544.
22. Lanzieri TM, Leung J, Caviness AC et al. Long--term outcomes of children with symptomatic congenital cytomegalovirus disease. J Perinatol 2017; 37 (7): 875–880. Doi: 10.1038/jp.2017.41.
23. Ríos-Barnés M, Fortuny C, Alarcón A et al. Renal involvement in congenital cytomegalovirus infection: a systematic review. Microorganisms 2021; 9 (6): 1304. Doi: 10.3390/microorganisms9061304.
24. Foulon I, Naessens A, Foulon W et al. Hearing loss in children with congenital cytomegalovirus infection in relation to the maternal trimester in which the maternal primary infection occurred. Pediatrics 2008; 122 (6): 1123–1127. Doi: 10.1542/peds.2008-0770.
25. Ross SA, Fowler KB, Ashrith G et al. Hearing loss in children with congenital cytomegalovirus infection born to mothers with preexisting immunity. J Pediatr 2006; 148 (3): 332–336. Doi: 10.1016/j.jpeds.2005.09.003.
26. Schuknecht HF. Pathology of the ear. In: Merchant SN, Nadol JB, Schuknecht HF. Pathology of the Inner Ear. 2nd ed. CT: People‘s Medical Pub. House-USA 1993: 687.
27. Fukuda S, Keithley EM, Harris JP. Experimental cytomegalovirus infection: viremic spread to the inner ear. Am J Otolaryngol 1988; 9 (3): 135–141. Doi: 10.1016/s0196-0709 (88) 80 019-x.
28. Carraro M, Almishaal A, Hillas E et al. Cytomegalovirus (CMV) infection causes degeneration of cochlear vasculature and hearing loss in a mouse model. J Assoc Res Otolaryngol 2017; 18 (2): 263–273. Doi: 10.1007/s10162-016- 0606-4.
29. Keithley EM, Woolf NK, Harris JP. Development of morphological and physiological changes in the cochlea induced by cytomegalovirus. Laryngoscope 1989; 99 (4): 409–414. Doi: 10.1288/00005537-198904000-00 010.
30. Corazzi V, Hatzopoulos S, Bianchini C et al. Vestibular and postural impairment in congenital cytomegalovirus infection. Int J Pediatr Otorhinolaryngol 2022; 152: 111005. Doi: 10.1016/j.ijporl.2021.111005.
31. Tanimura K, Yamada H. Potential biomarkers for predicting congenital cytomegalovirus infection. Int J Mol Sci 2018; 19 (12): 3760. Doi: 10.3390/ijms19123760.
32. Hughes BL, Gyamfi-Bannerman C. Diagnosis and antenatal management of congenital cytomegalovirus infection. Am J Obstet Gynecol 2016; 214 (6): B5–B11. Doi: 10.1016/j.ajog.2016.02.042.
33. Tanimura K, Tairaku S, Morioka I et al. Universal screening with use of immunoglobulin G avidity for congenital cytomegalovirus infection. Clin Infect Dis 2017; 65 (10): 1652–1658. Doi: 10.1093/cid/cix621.
34. Liesnard C, Donner C, Brancart F et al. Prenatal diagnosis of congenital cytomegalovirus infection: prospective study of 237 pregnancies at risk. Obstet and Gynecol 2000; 95 (6): 881–888. Doi: 10.1016/s0029-7844 (99) 00657-2.
35. Yinon Y, Farine D, Yudin MH et al. Cytomegalovirus infection in pregnancy. J Obstet Gynaecol 2010; 32 (4): 348–354. Doi: 10.1016/S1701-2163 (16) 34480-2.
36. Tanimura K, Tairaku S, Morioka I et al. Universal screening with use of immunoglobulin G avidity for congenital cytomegalovirus infection. Clin Infect Dis 2017; 65 (10): 1652–1658. Doi: 10.1093/cid/cix621.
37. Ohyama S, Fujioka K, Fukushima S et al. Diagnostic value of cytomegalovirus IgM antibodies at birth in PCR-Confirmed congenital cytomegalovirus infection. Int J Mol 2019; 20 (13): 3239. Doi: 10.3390/ijms20133239.
38. Vries JJC, Eijk AA, Wolthers KC et al. Real-time PCR versus viral culture on urine as a gold standard in the diagnosis of congenital cytomegalovirus infection. J Clin Virol 2012; 53 (2): 167–170. Doi: 10.1016/j.jcv.2011.11.006.
39. Smiljkovic M, Le Meur JB, Malette B et al. Blood Viral Load in the Diagnostic Workup of Congenital Cytomegalovirus Infection, J Clin Virol 2019; 122: 104231. Doi: 10.1016/j.jcv.2019. 104231.
40. Marsico C, Aban I, Kuo H et al. Blood Viral Load in Symptomatic Congenital Cytomegalovirus Infection. J Infect Dis 2019; 219 (9): 1398–1406. Doi: 10.1093/infdis/jiy695.
41. Boppana SB, Ross SA, Shimamura M et al. Saliva polymerase-chain-reaction assay for cytomegalovirus screening in newborns. N Engl J Med 2011; 364 (22): 2111–2118. Doi: 10.1056/ NEJMoa1006561.
42. Yamamoto AY, Mussi-Pinhata MM, Marin LJ et al. Is saliva as reliable as urine for detection of cytomegalovirus DNA for neonatal screening of congenital CMV infection? J Clin Virol 2006; 36 (3): 228–230. Doi: 10.1016/j.jcv.2006.03. 011
43. Luck SE, Wieringa JW, Blázquez-Gamero D et al. Congenital cytomegalovirus a European expert consensus statement on diagnosis and management. Pediatr Infect Dis J 2017; 36 (12): 1205–1213. Doi: 10.1097/INF.0000000000001 763.
44. Huang Y, Wang H, Li T et al. Comparison of detection strategies for screening and confirming congenital cytomegalovirus infection in newborns in a highly seroprevalent population: a mother-child cohort study. Lancet Reg Health West Pac 2021; 12: 100182. Doi: 10.1016/j.lanwpc.2021.100182
45. Boppana SB, Ross SA, Novak Z et al. Dried blood spot real-time polymerase chain reaction assays to screen newborns for congenital cytomegalovirus infection. JAMA 2010; 303 (14): 1375–1382. Doi: 10.1001/jama.2010.423.
46. Minnesota Department of Health. News release: Congenital cytomegalovirus approved for addition to newborn screening panel. 2022 [online]. Dostupné z: https: //www.health.state.mn.us/news/pressrel/2022/newborn020222.html.
47. Yassine BB, Hulkower R, Dollard S et al. A Legal Mapping Assessment of Cytomegalovirus-Related Laws in the United States. J Public Health Manag Pract 2022; 28 (2): E624–629. Doi: 10.1097/PHH.0000000000001401.
48. Children’s Health Quensland Hospital and Health Service. Treatment Guideline for Infants with Congenital CMV Disease (cCMV). 2022 [online]. Dostupné z: https: //www.childrens.health.qld.gov.au/wp-content/uploads/PDF/ams/gdl-01005.pdf.
49. Kimberlin DW, Lin CY, Sánchez PJ et al. Effect of ganciclovir therapy on hearing in symptomatic congenital cytomegalovirus disease involving the central nervous system: a randomized, controlled trial. J Ped 2003; 143 (1): 16–25. Doi: 10.1016/s0022-3476 (03) 00192-6.
50. Kimberlin DW, Acosta EP, Sánchez PJ et al. Pharmacokinetic and pharmacodynamic assessment of oral valganciclovir in the treatment of symptomatic congenital cytomegalovirus disease. J Infect Dis 2008; 197 (6): 836–845. Doi: 10.1086/528376.
51. Kimberlin DW, Jester PM, Sánchez PJ et al. Valganciclovir for symptomatic congenital cytomegalovirus disease. N Engl J Med 2015; 372 (10): 933–943. Doi: 10.1056/NEJMoa1404 599.
52. Bilavsky E, Shahar-Nissan K, Pardo J et al. Hearing outcome of infants with congenital cytomegalovirus and hearing impairment. Arch Dis Child 2016; 101 (5): 433–438. Doi: 10.1136/archdischild-2015-309154.
53. Jenks CM, Mithal LB, Hoff SR. Early identification and management of congenital cytomegalovirus. Otolaryngol Clin North Am 2021; 54 (6): 1117–1127. Doi: 10.1016/j.otc.2021.06. 006.
54. Barton M, Forrester MA, Jane M. Update on congenital cytomegalovirus infection: Prenatal prevention, newborn diagnosis, and management. 2020 [online]. Paediatr Child Health 2020; 25 (6): 395. Dostupné z: https: //cps.ca/documents/position/update-on-congenital-cytomegalovirus-infection-prenatal-prevention-newborn-diagnosis-and-management.
55. Schleiss MR, Bierle CJ, Swanson EC et al. Vaccination with a live attenuated cytomegalovirus devoid of a protein kinase R inhibitory gene results in reduced maternal viremia and improved pregnancy outcome in a guinea pig congenital infection model. J Virol 2015; 89 (19): 9727–9738. Doi: 10.1128/JVI.01419-15.
56. Pass RF, Zhang C, Evans A et al. Vaccine prevention of maternal cytomegalovirus infection. N Engl J Med 2009; 360 (12): 1191–1199. Doi: 10.1056/NEJMoa0804749.
57. Pesch MH, Saunders NA, Abdelnabi S. Cytomegalovirus Infection in Pregnancy: Prevention, Presentation, Management and Neonatal Outcomes. J Midwifery Womens Health 2021; 66 (3): 397–402. Doi: 10.1111/jmwh.13228.
Labels
Audiology Paediatric ENT ENT (Otorhinolaryngology)Article was published in
Otorhinolaryngology and Phoniatrics
2022 Issue 4
Most read in this issue
- Chronic rhinosinusitis of dental origin
- Compartmental tongue surgery
- Congenital cytomegalovirus infection from the viewpoint of otorhinolaryngologist
- The role of FEES and the dysphagia team in the management of patients after stroke disease in Hospital České Budějovice