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European Journal of Pediatrics

, Volume 169, Issue 9, pp 1061–1067 | Cite as

Treatment of symptomatic congenital cytomegalovirus infection with intravenous ganciclovir followed by long-term oral valganciclovir

  • Jacob Amir
  • Dana G. Wolf
  • Itzhak Levy
Original Paper

Abstract

Congenital cytomegalovirus infection is the most common cause of nonhereditary sensorineural hearing loss and an important cause of psychomotor retardation. Earlier studies showed that 6-weeks’ treatment with ganciclovir, starting in the neonatal period, prevented hearing deterioration at 6 months, but in one-fifth of the infants, the effect was not sustained at age 12 months. The aim of this preliminary retrospective study was to investigate the effectiveness and safety of long-term treatment with ganciclovir/valganciclovir for congenital cytomegalovirus infection. Twenty-three infants with culture-proven symptomatic congenital cytomegalovirus infection were treated with ganciclovir for 6 weeks followed by oral valganciclovir to age 12 months. Audiometry was performed at least three times in the first year, in addition to physical examination including neurological and developmental assessment. At age ≥1 year, hearing was normal in 76% of affected ears compared to baseline (54%). In 25 normal ears at birth no deterioration was found at ≥1 year. These results were significantly better than reported in a historical control group of similar infants treated for 6 weeks only (P= 0.001). Viral load monitoring demonstrated sustained virological response. Four of the children (18%) had mental retardation. The main side effect of treatment was transient neutropenia. In conclusion, prolonged therapy of symptomatic congenital CMV infection with intravenous ganciclovir followed by oral valganciclovir is safe, and it appears to lead to a better auditory outcome than short-term treatment.

Keywords

Ganciclovir Valganciclovir Congenital CMV 

Abbreviations

CMV

Congenital cytomegalovirus

BSER

Brainstem-evoked response

PICC

Peripherally inserted central venous catheter

PCR

Real-time polymerase chain reaction

Notes

Acknowledgement

We would like to thank Phyllis Curchack Kornspan for her editorial and secretarial services.

Conflicts of interest

All authors have no conflicts of interest.

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Copyright information

© Springer-Verlag 2010

Authors and Affiliations

  1. 1.Department of Pediatrics CSchneider Children’s Medical Center of IsraelPetah TiqwaIsrael
  2. 2.Tel Aviv UniversityTel AvivIsrael
  3. 3.Department of Clinical MicrobiologyHadassah University HospitalJerusalemIsrael
  4. 4.Pediatric Infectious Disease UnitSchneider Children’s Medical Center of IsraelPetah TiqwaIsrael

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