Abstract Details

<< Back to Detailed Agenda

9/24/2018  |   10:00 AM - 10:30 AM   |  Diamond Ballroom II

Long-Term Hearing Outcomes of Symptomatic CMV Infected Children Treated with Valgangciclovir

OBJECTIVES: To evaluate the long-term trends in hearing outcomes among symptomatic CMV patients treated with vanganciclovir. METHODS: A retrospective chart review of symptomatic CMV patients treated with valgangcyclovir was completed for 2003-present. The primary endpoint was the change in best ear hearing scores prior to treatment and after several follow-up audiograms. An additional endpoint included change in hearing for right and left ears. Clinically significant worsening hearing in the best ear was defined as the occurrence of either: a) 10 dB or greater increase in minimum response level (MRL) at both 2 and 4 kHz, b) 15 dB or greater increase at either frequency, or c) cochlear implantation. A paired-sample t-test was used to evaluate differences in the mean change of hearing scores. RESULTS: Sixteen symptomatic CMV infected children who underwent treatment with vanganciclovir were included in this study. There was a measurable worsening, but not a statistically significant change in the baseline and follow-up best hearing scores, where the mean worsening change is 11.88dB (95% CI: -1.11 – 24.86, p-value=0.070). However, of the 16 patients, 14 (87.5%, p-value<0.001) were found to have clinically significant worsening hearing after an average of 3.17 years (range: 0.26 – 9.98) of follow-up. The mean change in hearing scores for the left ear was 14.22 dB (95% CI: 2.25 – 26.19, p-value=0.023). The mean change in hearing scores for the right ear was 15.47 dB (95% CI: 1.52 – 29.42, p-value=0.032). Two patients eventually underwent cochlear implantation (CI), and ten more are being considered candidates for CI. CONCLUSION: The proportion of children with worsening hearing scores and who underwent cochlear implantation suggest that valganciclovir provides only a short-term improvement in hearing outcomes. These preliminary post-hoc findings suggest the need for a more rigorous evaluation and inclusion of a control group.

  • Two randomized clinical trials report improved hearing outcomes in symptomatic CMV infected children treated with valganciclovir
  • Illustrate lack of long term hearing follow-up of symptomatic cCMV infected children treated with valganciclovir
  • Many symptomatic CMV infected children treated with valganciclovir will develop worsening hearing thresholds.

Presentation:
This presentation has not yet been uploaded.

Handouts:
No handouts have been uploaded.


Albert Park (Primary Presenter), albert.park@hsc.utah.edu;
Dr. Park is the chief for Pediatric Otolaryngology at the University of Utah. He is the principal investigator for an NIH funded multi-institutional clinical trial to determine whether the antiviral drug, valganciclovir can improve hearing outcomes for children with cytomegalovirus (CMV), a very common and understudied cause of childhood hearing loss.He also established a CMV working group comprising of pediatric genetics, infectious disease, otolaryngology, audiology, neurology, department of health and ARUP laboratories to streamline clinical and research initiatives in this field.

      ASHA DISCLOSURE:

Financial - No relevant financial relationship exists.

Nonfinancial - No relevant nonfinancial relationship exists.


      AAA DISCLOSURE:

Financial - Receives support from NIH.  




Hilary McCrary (Co-Author), hilary.mccrary@hsc.utah.edu;
Dr. McCrary is an otolaryngology resident at the University of Utah

      ASHA DISCLOSURE:

Financial -

Nonfinancial -


      AAA DISCLOSURE:

Financial - No relevant financial relationship exists.




Xioaming Sheng (Co-Author), xiaoming.sheng@hsc.utah.edu;
Xiaoming Sheng, Ph.D., is a Research Professor of Pediatrics and a statistician in the Department of Pediatrics.

      ASHA DISCLOSURE:

Financial -

Nonfinancial -


      AAA DISCLOSURE:

Financial - No relevant financial relationship exists.




Tom Greene (Co-Author), tom.greene@hsc.utah.edu;
Dr. Greene is the Chief of the Division of Biostatistics at the University of Utah

      ASHA DISCLOSURE:

Financial -

Nonfinancial -


      AAA DISCLOSURE:

Financial - No relevant financial relationship exists.