Abstract Details
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:
17739_9659AlbertPark.pdf
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.
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ASHA DISCLOSURE: Financial - No relevant financial relationship exists. Nonfinancial - No relevant nonfinancial relationship exists. |
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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
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ASHA DISCLOSURE: Financial - Nonfinancial - |
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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.
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ASHA DISCLOSURE: Financial - Nonfinancial - |
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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
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ASHA DISCLOSURE: Financial - Nonfinancial - |
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AAA DISCLOSURE: Financial - No relevant financial relationship exists. |