Shin Koyano1,2, Ichiro Morioka3, Akira Oka4, Hiroyuki Moriuchi5, Kimisato Asano6, Yushi Ito7, Tetsushi Yoshikawa8, Hideto Yamada9, Tatsuo Suzutani10, Naoki Inoue11,12. 1. Department of Pediatrics, Asahikawa Medical University, Hokkaido, Japan. 2. Ujiie Memorial Clinic for Children, Hokkaido, Japan. 3. Department of Pediatrics, Kobe University Graduate School of Medicine, Hyogo, Japan. 4. Department of Pediatrics, Tokyo University, Tokyo, Japan. 5. Department of Pediatrics, Nagasaki University, Nagasaki, Japan. 6. Department of Obstetrics and Gynecology, Fukushima Medical University, Fukushima, Japan. 7. Department of Maternal and Perinatal Services, National Center for Child Health and Development, Tokyo, Japan. 8. Department of Pediatrics, Fujita Health University, Aichi, Japan. 9. Department of Obstetrics and Gynecology, Kobe University Graduate School of Medicine, Hyogo, Japan. 10. Department of Microbiology, Fukushima Medical University, Fukushima, Japan. 11. Department of Virology I, National Institute of Infectious Diseases, Tokyo, Japan. 12. Department of Microbiology and Immunology, Gifu Pharmaceutical University, Gifu, Japan.
Abstract
BACKGROUND: The aim of this study was to evaluate the outcome of congenital cytomegalovirus (CMV) infection identified on urine-filter screening assay at >2 years' follow up, and to observe the clinical outcomes after anti-CMV treatment. METHODS: Sixty of 72 congenital CMV patients were enrolled and clinically observed for >2 years. Forty-three were asymptomatic at birth; seven were symptomatic at birth but untreated with anti-CMV drugs; and 10 were symptomatic and treated with anti-CMV drugs. RESULTS: Of the 43 asymptomatic patients, three developed hearing loss or language disability for which association with congenital CMV has been repeatedly reported, and two had neurological sequelae of which the etiology was unclear, indicating that the rate of CMV-associated late-onset sequelae was 7-12%. All seven symptomatic infants without treatment developed sequelae, while three of the 10 treated patients were free from any sequelae. CONCLUSIONS: The rate of late-onset sequelae observed in Japan is similar to that reported in the USA and Europe. The treatment of symptomatic patients with antiviral agents results in favorable clinical outcomes. Thus, newborn urine-filter paper screening of congenital CMV infection is warranted.
BACKGROUND: The aim of this study was to evaluate the outcome of congenital cytomegalovirus (CMV) infection identified on urine-filter screening assay at >2 years' follow up, and to observe the clinical outcomes after anti-CMV treatment. METHODS: Sixty of 72 congenital CMV patients were enrolled and clinically observed for >2 years. Forty-three were asymptomatic at birth; seven were symptomatic at birth but untreated with anti-CMV drugs; and 10 were symptomatic and treated with anti-CMV drugs. RESULTS: Of the 43 asymptomatic patients, three developed hearing loss or language disability for which association with congenital CMV has been repeatedly reported, and two had neurological sequelae of which the etiology was unclear, indicating that the rate of CMV-associated late-onset sequelae was 7-12%. All seven symptomatic infants without treatment developed sequelae, while three of the 10 treated patients were free from any sequelae. CONCLUSIONS: The rate of late-onset sequelae observed in Japan is similar to that reported in the USA and Europe. The treatment of symptomatic patients with antiviral agents results in favorable clinical outcomes. Thus, newborn urine-filter paper screening of congenital CMV infection is warranted.