Long-Term Clinical, Audiological, Visual, Neurocognitive and Behavioral Outcome in Children With Symptomatic and Asymptomatic Congenital Cytomegalovirus Infection Treated With Valganciclovir
Arianna Turriziani Colonna, Danilo Buonsenso, Davide Pata, Gilda Salerno, Daniela Pia Rosaria Chieffo, Domenico M. Romeo, Valerio Faccia, Guido Conti, Fernando Molle, Antonio Baldascino, Chiara de Waure, Anna Acampora, Rita Luciano, Rosaria Santangelo, Piero Valentini
Abstract
Background Cytomegalovirus (CMV) is the most common cause of congenital infection in humans. However, there are no enough data on long-term outcome of newborns with congenital CMV (cCMV) infection, particularly for those asymptomatic at birth. For this reason, we performed this study to evaluate long-term audiological, visual, neurocognitive and behavioral outcome in children with symptomatic and asymptomatic cCMV infection treated with oral Valganciclovir (VGC). Methods 8-year retrospective study of children with cCMV infection treated with oral valganciclovir. Children underwent audiological, visual, neurocognitive and behavioral follow-up. Results Study population: 36 newborns with confirmed cCMV infection were evaluated: 12 (33.3%) symptomatic at birth and 24 asymptomatic (66.7%). Avarage follow-up was 5.12 years. Cognitive development: 8/35 (22.8%) children scored below the norm. 3/35(8.5%) children achieved a borderline score. No one had cognitive impairment. Cognitive assessment scales resulted abnormal in 4/35 children (11.4%). Neuropsychological tests: 11/21 children (52.4%) achieved abnormal scores. The language evaluation gave pathological results in 6/21 (28.5%) children. Analysis of the child's behaviour: 7/28 (25%) children in total obtained alarming scores Audiological follow-up: 6/35 children (17.1%) developed SNHL, all symptomatic at birth except one Ophthalmological follow-up: None of the 34 children evaluateddeveloped CMV retinopathy. Conclusions Our study shows that both symptomatic and asymptomatic newborns with cCMV infection develop long-term sequelae, particularly in the behavioral and communicative areas, independently from the trimester of maternal infection.