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9/24/2018  |   2:15 PM - 2:45 PM   |  Diamond Ballroom II

Can Congenital CMV-related Hearing Loss be Evaluated Without Systematic Neonatal CMV Screening?

Background: The contribution of congenital CMV infection (cCMV) for permanent hearing loss (HL) may be underestimated without universal cCMV screening. We aimed to determine the contribution of cCMV to permanent neonatal HL in a highly seropositive population, and to verify the proportion of cCMV-related neonatal HL that can be detected by targeting infants who fail universal hearing screening (UNHS) for cCMV testing. Study design: A total of 11,861 neonates had UNHS and were screened for cCMV by saliva PCR and confirmed by testing urine within 3 weeks of age. Hearing loss was defined by follow up diagnostic audiological evaluation. Results: Among 11,861 infants, 67 (6 per 1000 live births; 95%CI:4-7 per 1000) were identified with cCMV. Of the 97 (8 per 1000 live births) infants who failed UNHS, 22 (1.8 per1000 live births; 95%CI:1.1-2.8 per 1000) were confirmed with HL. cCMV occurred in 8/22 (36.4%; 95%CI:17.2-59.3) with permanent HL. Among infants who failed UNHS, 9 were CMV-infected; 7 had SNHL, one infant had normal hearing and one did not undergo a hearing evaluation. Of the 11,764 infants (58 with cCMV) who passed UNHS, one with cCMV was confirmed with HL at 21 days. Overall, UNHS identified 7/8 (87.5%; 95%CI:47.3-99.7) infants with cCMV-related HL and missed 1/8(12.5%). The prevalence of cCMV-related HL among CMV-infected infants was 8/66(12.12%). No late onset of HL was detected during a median follow-up of 18 months (range:12-48 months). Conclusions: One-third of all permanent HL identified by UNHS was related to cCMV. Integrating targeted cCMV screening among infants who fail UNHS will likely identify the majority of CMV-related neonatal HL in this population. However, all infants with delayed onset CMV-related HL may not have been identified because the shorter follow-up.

  • To determine the contribution of congenital CMV infection to overall neonatal permanent hearing loss
  • To verify the importance of congenital CMV infection as a cause of hearing loss in a highly seropositive population
  • To determine the proportion of congenital CMV-related hearing loss that can be detected by targeting infants who fail universal hearing screening for CMV testing.

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Aparecida Y. Yamamoto (Primary Presenter,Author), yulie@fmrp.usp.br;
Dr Yamamoto is an investigator in the Department of Pediatrics, Ribeirão Preto Medical School, University of São Paulo, Brazil. She is a co-PI for the BRaCHS Study and she has experience in the field of medicine, with emphasis on mother-to-child transmission infections, mainly on the following topics: congenital and perinatal infections, transmission, diagnosis and consequences in the child, with emphasis on congenital CMV infection.

      ASHA DISCLOSURE:

Financial - No relevant financial relationship exists.

Nonfinancial - No relevant nonfinancial relationship exists.


      AAA DISCLOSURE:

Financial - No relevant financial relationship exists.




Adriana Ribeiro Tavares Anastacio (Author,Co-Author), anastaci@fmrp.usp.br;
She is currently a Ph.D. Professor at the Medical School of Ribeirão Preto, University of São Paulo. Her research field has emphasis on Audiological Diagnosis, working mainly on the following topics: early diagnosis of hearing loss in infants, hearing health of the child, adult and elderly .

      ASHA DISCLOSURE:

Financial -

Nonfinancial -


      AAA DISCLOSURE:

Financial - No relevant financial relationship exists.




Eduardo Massuda Tanaka (Author,Co-Author), edumassuda@fmrp.usp.br;
Dr Tanaka is currently a Ph.D. Professor at the Medical School of Ribeirão Preto, University of São Paulo, Department of Otorhinolaryngology Division of the Department of Ophthalmology, Otorhinolaryngology and Head and Neck Surgery.

      ASHA DISCLOSURE:

Financial -

Nonfinancial -


      AAA DISCLOSURE:

Financial - No relevant financial relationship exists.




Myriam Isaac (Author,Co-Author), mylis@fmrp.usp.br;
Dr Isaac is currently a professor at the Department of Ophthalmology, Otorhinolaryngology and Head and Neck Surgery of the Medical School of Ribeirão Preto-USP, in an Integrated Dedication to Research and Teaching Regime. He works in Otology, Cochlear Implant, Hearing Rehabilitation, Hearing Neurophysiology, Audiology, Phoniatrics and Communication Disorders. Research also on linguistic, socio-cultural and development aspects of the deaf person and on bilingualism and deafness.

      ASHA DISCLOSURE:

Financial -

Nonfinancial -


      AAA DISCLOSURE:

Financial - No relevant financial relationship exists.




Alessandra Kerli Manfredi (Author,Co-Author), alekerli@yahoo.com;
She has a Master's degree in Public Health Nursing from the University of São Paulo at Ribeirão Preto College of Nursing and a doctorate in Medical Sciences from the University of São Paulo at Ribeirão Preto Medical School . She is currently a research collaborator and Speech Therapist. She has experience in speech therapy, with emphasis in clinical audiology, working mainly in the following subjects: audiological diagnosis in the newborn, in the child and in the adult, occupational audiology, neonatal hearing screening and auditory health.

      ASHA DISCLOSURE:

Financial -

Nonfinancial -


      AAA DISCLOSURE:

Financial - No relevant financial relationship exists.




Karen B. Fowler (Author,Co-Author), kfowler@uab.edu;
Dr. Fowler is a Professor in the Division of Infectious Diseases in the Department of Pediatrics at the University of Alabama at Birmingham.

      ASHA DISCLOSURE:

Financial - Receives Consulting fee for Consulting from Merck.  

Nonfinancial - No relevant nonfinancial relationship exists.


      AAA DISCLOSURE:

Financial - Receives support from NIH, Merck.  




Suresh Boppana (Author,Co-Author), sboppana@peds.uab.edu;
Dr. Boppana is a Professor in the Division of Infectious Diseases in the Department of Pediatrics and was the PI of the NIDCD CHIMES Study.

      ASHA DISCLOSURE:

Financial -

Nonfinancial -


      AAA DISCLOSURE:

Financial - No relevant financial relationship exists.




William Britt (Author,Co-Author), WBritt@peds.uab.edu;
Dr. Britt is a Professor, Chair in the Division of Infectious Diseases in the Department of Pediatrics of University of Alabama

      ASHA DISCLOSURE:

Financial -

Nonfinancial -


      AAA DISCLOSURE:

Financial - No relevant financial relationship exists.




Marisa Mussi-Pinhata (Co-Presenter,Co-Author), mmmpinha@fmrp.usp.br;
Marisa M. Mussi-Pinhata, MD, has a broad background in Pediatrics and Clinical Research, with specific training and expertise in neonatology and maternal/infant infections. Since her postdoctoral research fellowship in HIV/AIDS in the US, she has been involved with research with focus on HIV, CMV, and hepatitis. She is a leader of a Clinical Research Site that is part of international research networks in Infectious Diseases. Currently she is a Full Professor of Pediatrics and occupies the function of chief of the Department of Pediatrics of Ribeirão Preto Medical School, University of São Paulo, Brazil. She has authored or co-authored 69 peer-reviewed publications and has received several research supports and awards for research works.

      ASHA DISCLOSURE:

Financial - No relevant financial relationship exists.

Nonfinancial - No relevant nonfinancial relationship exists.


      AAA DISCLOSURE:

Financial - No relevant financial relationship exists.