Congenital Cytomegalovirus Is the Second Most Frequent Cause of Bilateral Hearing Loss in Young French Children - 26/02/13

Doi : 10.1016/j.jpeds.2012.08.009

Véronique Avettand-Fenoël, PharmD, PhD ^1,², Sandrine Marlin, MD ³, Christelle Vauloup-Fellous, PharmD, PhD ^4,⁵, Natalie Loundon, MD ^6,⁷, Martine François, MD ⁸, Vincent Couloigner, MD, PhD ^2,⁹, Isabelle Rouillon, MD ^6,⁷, Valérie Drouin-Garraud, MD ¹⁰, Laurence Laccourreye, MD ⁹, Françoise Denoyelle, MD ^6,⁷, Tiffany Guilleminot, Lab Tech ^1,², Sophie Grabar, MD, PhD ^2,¹¹, Marianne Leruez-Ville, MD, PhD ^1,^2,^⁎
¹ Laboratory of Virology, Reference National Center for Cytomegalovirus-Associated Laboratory, Hospital Necker-Enfants-Malades, Assistance Publique-Hôpitaux de Paris, Paris, France
² University Paris, Descartes, Sorbonne Paris Cité, Paris, France
³ Department of Genetics and Embryology, Reference Center for Genetic Deafness, Hospital Trousseau, Assistance Publique-Hôpitaux de Paris, Paris, France
⁴ INSERM, U764, University Paris-Sud, Paris, France
⁵ Department of Microbiology, Hôpital Antoine Beclere, Assistance Publique-Hôpitaux de Paris, Clamart, France
⁶ Department of Pediatrics Otorhinolaryngology and Head and Neck Surgery, Hospital Trousseau, Assistance Publique-Hôpitaux de Paris, Paris, France
⁷ INSERM U58, University Pierre et Marie Curie, Paris, France
⁸ Department of Pediatric Otorhinolaryngology, Hospital Robert Debré, Assistance Publique-Hôpitaux de Paris, Paris, France
⁹ Department of Pediatrics Otorhinolaryngology, Hospital Necker-Enfants-Malades, Assistance Publique-Hôpitaux de Paris, University Paris Descartes, Sorbonne, Paris, France
¹⁰ Unit of Clinical Genetics, CHRU Rouen, Rouen, France
¹¹ Unit of Biostatistics and Epidemiology, Hospital Hotel-Dieu, Assistance Publique-Hôpitaux de Paris, Paris, France

Reprint requests: Marianne Leruez-Ville, Hospital Necker-Enfants-Malades, 149 rue de Sèvres, 75015 Paris, France.

Abstract

Objective

To estimate the prevalence of congenital cytomegalovirus (cCMV) among causes of bilateral hearing loss in young French children.

Study design

Children <3 years old with hearing loss were prospectively included at their first visit to a referral center. Cytomegalovirus polymerase chain reaction was performed on dried blood spots from Guthrie cards. Medical records were reviewed.

Results

One hundred children with bilateral hearing loss were included at a median age of 15 months; the prevalence of cCMV was 8% (8/100) (95% CI, 2.7%-13.3%) in this population and 15.4% (8/52) in the subpopulation of children with profound bilateral hearing loss. Delayed neurodevelopment and brain abnormalities on computed tomography scan were found more often in children with cCMV than in children with hearing loss without cCMV (P = .027, P = .005). In 6 of 8 cCMV cases, cCMV infection had not been diagnosed before the study.

Conclusions

In a comprehensive study of the causes of bilateral hearing loss in young French children, cCMV is the second most frequent cause of hearing loss after connexin mutations. It underlines that a majority of French children with hearing loss and cCMV are not diagnosed early and therefore may not benefit from early intervention including the possibility of neonatal antiviral treatment. These results make the case for promoting systematic cytomegalovirus screening in neonates with confirmed hearing loss identified through neonatal hearing screening.

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Keyword : CMV, cCMV, CT, DBS, NICU, PCR

Plan

Methods

Statistical Analyses

Results

Results of CMV PCR in DBS

Characteristics of Children with cCMV

Causes of Hearing Loss in the Population of Children with Bilateral Hearing Loss

Discussion

Supported by La Fondation de l’Avenir (ET6-430). V.A.-F. has received travel support to meetings from Argene. C.V.-F. has received grants from BioMérieux. M.L.-V. has received travel support to meetings from Argene and payment for lectures from Diasorin. The other authors declare no conflicts of interest.

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Vol 162 - N° 3

P. 593-599 - mars 2013 Retour au numéro

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Congenital Cytomegalovirus Is the Second Most Frequent Cause of Bilateral Hearing Loss in Young French Children - 26/02/13

Abstract

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