Kummer Peter, Marcrum Steven C
Section Phoniatrics and Pediatric Audiology, Department of Otolaryngology, University Hospital Regensburg, Franz-Josef-Strauß-Allee 11, 93053 Regensburg, Germany.
Department of Otolaryngology, University Hospital Regensburg, Franz-Josef-Strauß-Allee 11, 93053 Regensburg, Germany.
Int J Neonatal Screen. 2018 Jun 19;4(2):20. doi: 10.3390/ijns4020020. eCollection 2018 Jun.
Evidence-based guidelines for the prevention, diagnosis and treatment of congenital cytomegalovirus (cCMV) were recently released by two independent expert groups. Of particular emphasis was the relationship between cCMV and sensorineural hearing loss (SNHL), a major component of the virus' overall disease burden. In this study, a literature review was performed to estimate the proportion of cCMV-related SNHL cases, which might be identified through selective cCMV testing following failed newborn hearing screening. Furthermore, it was of interest to estimate the potential benefit of emerging antiviral therapies. Currently, at most 10% of cCMV-related SNHL is likely to be identified clinically. Through use of a selective cCMV testing protocol, however, a significant improvement in the identification rate can be achieved. Recent expert group statements strongly recommend antiviral therapy in cases of moderate-to-severe disease, especially in the presence of central nervous system involvement. Though differences exist between recommendations in instances of isolated SNHL or SNHL in combination with only mild symptoms, the majority of experts in both groups offered at least a weak recommendation for antiviral treatment. Available results suggest antiviral treatment could therefore benefit a meaningful proportion of newborns referred for cCMV testing following failed newborn hearing screening.
两个独立的专家小组最近发布了先天性巨细胞病毒（cCMV）预防、诊断和治疗的循证指南。cCMV与感音神经性听力损失（SNHL）之间的关系受到特别强调，SNHL是该病毒总体疾病负担的一个主要组成部分。在本研究中，进行了一项文献综述，以估计cCMV相关SNHL病例的比例，这些病例可能通过新生儿听力筛查未通过后的选择性cCMV检测得以识别。此外，估计新兴抗病毒疗法的潜在益处也很有意义。目前，临床上可能最多只能识别出10%的cCMV相关SNHL病例。然而，通过使用选择性cCMV检测方案，可以显著提高识别率。最近专家小组的声明强烈建议在中重度疾病的情况下进行抗病毒治疗，尤其是在存在中枢神经系统受累的情况下。虽然在孤立性SNHL或仅伴有轻微症状的SNHL病例中的建议存在差异，但两组中的大多数专家至少对抗病毒治疗提出了微弱的建议。现有结果表明，抗病毒治疗因此可能使相当一部分在新生儿听力筛查未通过后被转诊进行cCMV检测的新生儿受益。
