Laboratory of Virology, Reference National Center for Cytomegalovirus-Associated Laboratory, Hospital Necker-Enfants-Malades, Assistance Publique-Hôpitaux de Paris, Paris, France; University Paris, Descartes, Sorbonne Paris Cité, Paris, France.
J Pediatr. 2013 Mar;162(3):593-9. doi: 10.1016/j.jpeds.2012.08.009. Epub 2012 Sep 26.
To estimate the prevalence of congenital cytomegalovirus (cCMV) among causes of bilateral hearing loss in young French children.
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.
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.
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.
评估先天性巨细胞病毒（cCMV）在法国年轻儿童双侧听力损失病因中的流行率。
前瞻性纳入首次就诊于转诊中心的年龄<3 岁的双侧听力损失儿童。使用 Guthrie 卡上的干血斑进行巨细胞病毒聚合酶链反应。回顾病历记录。
100 例双侧听力损失儿童纳入研究，中位年龄为 15 个月；该人群中 cCMV 的流行率为 8%（8/100）（95%CI：2.7%-13.3%），而在双侧重度听力损失的儿童亚群中为 15.4%（8/52）。与无 cCMV 的听力损失儿童相比，cCMV 感染儿童更常出现神经发育延迟和 CT 扫描脑部异常（P=0.027，P=0.005）。在 8 例 cCMV 病例中，有 6 例在研究前未诊断出 cCMV 感染。
在对法国年轻儿童双侧听力损失病因的全面研究中，cCMV 是继缝隙连接突变之后导致听力损失的第二大常见原因。这表明，大多数患有听力损失和 cCMV 的法国儿童未得到早期诊断，因此可能无法受益于早期干预，包括新生儿抗病毒治疗的可能性。这些结果表明，需要促进在通过新生儿听力筛查确诊的伴有听力损失的新生儿中进行系统的巨细胞病毒筛查。
