2024 Early Hearing Detection & Intervention Conference
March 17-19, 2024 • Denver, CO
| Late-Onset Hearing Loss and Antiviral Therapy for Congenital Cytomegalovirus Infection
Late-Onset Hearing Loss and Antiviral Therapy for Congenital Cytomegalovirus Infection
Congenital cytomegalovirus (CMV) is the leading non-genetic cause of sensorineural hearing loss (SNHL) in children. While SNHL is often present at birth, as many as 25% of congenital CMV-infected infants develop late-onset hearing loss. Antiviral therapy improves hearing outcomes, but its effect on the occurrence of late-onset SNHL is not fully known. Thus, our objective was to describe the prevalence of late-onset SNHL among congenital CMV-infected children treated with antiviral therapy in the first month of age. From 2013 to 2019, infants with congenital CMV infection referred to Nationwide Children’s Hospital’s (NCH) NEO-ID Clinic, underwent complete evaluation including hearing testing. Demographic, clinical, laboratory, and radiographic data were obtained and managed using REDCap. Infants who passed the newborn hearing screen and subsequently developed late-onset SNHL were identified and receipt of antiviral therapy was assessed. Statistical analyses were performed using GraphPad Prism for macOS version 8.3.0. During the 6-year study period, 99 infants had congenital CMV infection and 69 (70%) of them passed the newborn hearing screen. 46 (46%) neonates received antiviral therapy (1, ganciclovir; 38, valganciclovir; 7, both) for clinically apparent congenital CMV infection. One (2%) child developed late-onset SNHL. This infant was born at 37 weeks’ gestation with microcephaly and cerebral calcifications and was diagnosed with congenital CMV infection at 8 days of age. Valganciclovir was started at 9 days of age. He developed mild unilateral SNHL at 1 month of age while on treatment and, subsequently, right severe-profound SNHL and left mild-moderate SNHL. In comparison, among 23 infants with clinically inapparent disease who passed the newborn hearing screen and did not receive antiviral therapy, 5 (22%) subsequently developed SNHL (p=0.014). Infants who received antiviral therapy for clinically apparent congenital CMV infection had significantly less late-onset SNHL than untreated infants, supporting a hearing protective effect of antiviral treatment.
Presentation:
23278_13580ALEXANDRAMEDORO.pdf
Handouts:
Handout is not Available
Transcripts:
CART transcripts are NOT YET available, but will be posted shortly after the conference
Presenters/Authors
ALEXANDRA MEDORO
(POC,Primary Presenter,Author), Nationwide Children's Hospital, alexandra.medoro@nationwidechildrens.org;
Dr. Medoro is a neonatal-perinatal medicine fellow at Nationwide Children's Hospital. She completed her medical training at The Ohio State University College of Medicine and her pediatric residency at Nationwide Children's Hospital. She has a particular interest in congenital cytomegalovirus infection. Following completion of her neonatal-perinatal medicine fellowship, she will be completing additional training in pediatric infectious disease.
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Ursula Findlen
(Co-Author), Nationwide Children's Hospital, ursula.findlen@nationwidechildrens.org;
Ursula M. Findlen, Ph.D., is the Director of Audiology Research in the Division of Clinical Therapies- Audiology Department at Nationwide Children’s Hospital and an Assistant Professor-Clinical at The Ohio State University College of Medicine, Department of Otolaryngology- Head and Neck Surgery. Dr. Findlen engages in clinical practice and research endeavors related to pediatric (re)habilitative audiology, particularly in regards to a multidisciplinary team approach to family-centered care. Her research interests include infant diagnostics and improving outcomes of children with hearing loss through systematic quality improvement and population health endeavors.
ASHA DISCLOSURE:
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• Receives Grants for Independent contractor from Advanced Bionics, LLC.
• Receives Grants for Independent contractor from Decibel Therapeutics.
• Receives Salary for Employment from Nationwide Children's Hospital.
• Receives Salary for Employment from The Ohio State University College of Medicine.
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No relevant nonfinancial relationship exists.
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Financial relationship with Advanced Bionics, LLC (research grant)
Decibel Therapeutics (research grant
Nationwide Children's Hospital (employment)
The Ohio Statue University College of Medicine (employment).
Nature: Research grant support
Employment.
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No relevant nonfinancial relationship exists.
Holly Gerth
(Co-Author), Nationwide Childrens Hospital, Holly.Gerth@nationwidechildrens.org;
Holly Gerth, AuD, is an inpatient pediatric audiologist and has practiced audiology for more than 7 years. At Nationwide Children’s, Holly is responsible for answering all inpatient consults, performing diagnostic hearing evaluations in a variety of settings (Operating Room, Procedure Center, bedside testing) and managing inpatients with hearing loss. Before working at Nationwide Children’s Hospital, Holly worked as a pediatric audiologist at Children’s Healthcare of Atlanta.
Holly enjoys working with children with hearing loss and their families. She strives to provide the most comprehensive care possible, aiming to put her patients on the path to achieve success. Holly has an interest in audiologic electrophysiology and universal newborn hearing screening. She is an extern supervisor and active in multiple clinical outcome groups.
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Prashant Malhotra
(Co-Author), Nationwide Children's Hospital, Prashant.Malhotra@nationwidechildrens.org;
Prashant Solanki Malhotra, MD, FAAP, is a member of the Department of Otolaryngology and the Hearing Program at Nationwide Children’s Hospital and an Assistant Professor in the Department of Otolaryngology – Head and Neck Surgery at The Ohio State University College of Medicine. Dr. Malhotra received his medical degree from Case Western Reserve University, Cleveland, Ohio, in 2004. He completed an internship in General Surgery at Thomas Jefferson University Hospital, and completed his residency in Otolaryngology, Head and Neck Surgery at Thomas Jefferson University Hospital and Alfred I. duPont Hospital for Children. He spent an additional year as a fellow and clinical instructor of Pediatric Otolaryngology at Lucile Packard Children’s Hospital, Stanford University. Dr. Malhotra’s clinical and research interests primarily focus on problems relating to pediatric hearing loss and cochlear implantation, pediatric head and neck masses including malignancies, and all other aspects of pediatric otolaryngology and facial reconstructive surgery.
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Oliver Adunka
(Co-Author), Nationwide Children's Hospital, oliver.adunka@nationwidechildrens.org;
Dr. Oliver F. Adunka is the division director of otology, neurotology, and cranial base surgery at The Ohio State University in Columbus, OH. He is also the director of Pediatric Otology at Nationwide Children’s Hospital, one of the largest institution’s of its kind in the United States
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Masako Shimamura
(Co-Author), Nationwide Children's Hospital, masako.shimamura@nationwidechildrens.org;
Dr. Shimamura is a pediatric infectious disease physician.
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Cory Hanlon
(Co-Author), Nationwide Children's Hospital, cory.hanlon@nationwidechildrens.org;
Cory Hanlon is a member of the research staff at Nationwide Children's Hospital.
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Traci Pifer
(Co-Author), Nationwide Children's Hospital, traci.pifer@nationwidechildrens.org;
Traci Pifer is a member of the research staff at Nationwide Children's Hospital.
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Pablo Sanchez
(Co-Author), Nationwide Children's Hospital, pablo.sanchez@nationwidechildrens.org;
Dr. Sanchez is a neonatologist and pediatric infectious disease physician.
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