Efficacy of Valganciclovir Treatment Depends on the Severity of Hearing Dysfunction in Symptomatic Infants with Congenital Cytomegalovirus Infection

• Published in: International journal of molecular sciences Vol. 20; no. 6; p. 1388
• Main Authors: Ohyama, Shohei, Morioka, Ichiro, Fukushima, Sachiyo, Yamana, Keiji, Nishida, Kosuke, Iwatani, Sota, Fujioka, Kazumichi, Matsumoto, Hisayuki, Imanishi, Takamitsu, Nakamachi, Yuji, Deguchi, Masashi, Tanimura, Kenji, Iijima, Kazumoto, Yamada, Hideto
• Format: Journal Article
• Language: English
• Published: Switzerland MDPI AG 19.03.2019; MDPI
• Subjects: Age; Antiviral drugs; Communication; Cytomegalovirus; Deoxyribonucleic acid; DNA; Drug dosages; Ears & hearing; Hearing loss; Infections; Neutropenia; Urine; United States > US; severity; valganciclovir; auditory brainstem response; hearing dysfunction; congenital cytomegalovirus infection
• ISSN: 1422-0067; 1661-6596; 1422-0067
• DOI: 10.3390/ijms20061388

Although earlier studies have shown that antiviral treatment regimens using valganciclovir (VGCV) improved hearing function in some infants with congenital cytomegalovirus (CMV) infection; its efficacy on the severity of hearing dysfunction is unclear. We conducted a prospective study among 26 infants with congenital CMV infections from 2009 to 2018. Oral VGCV (32 mg/kg/day) was administered for 6 weeks (November 2009 to June 2015; n = 20) or 6 months (July 2015 to March 2018, n = 6). Hearing function was evaluated by measuring the auditory brainstem response before VGCV treatment and at 6 months. Hearing dysfunction, defined as a V-wave threshold >40 dB, was categorized into: most severe, ≥91 dB; severe, 61–90 dB; and moderate, 41–60 dB. Hearing improvement was defined as a decrease of ≥20 dB from the pretreatment V-wave threshold. Of 52 ears in 26 infants with congenital CMV infection, 29 (56%) had hearing dysfunction, and of 29 ears, 16 (55%) improved after VGCV treatment. Although, 16 (84%) of 19 ears with moderate or severe hearing dysfunction improved after treatment (p < 0.001), 10 ears with the most severe form did not. In conclusion, VGCV treatment is effective in improving moderate and severe hearing dysfunction in infants with congenital CMV infection.