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Selecting neonates with congenital cytomegalovirus infection for ganciclovir therapy

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Abstract

Objective

The objective of this study is to look for evidence based or scientific guidelines for selection of newborns with congenital cytomegalovirus (CMV) infection that might benefit from treatment with ganciclovir.

Materials and methods

A literature search was conducted involving the MEDLINE database and the Cochrane Collaboration Library. Abstracts were reviewed to select pertinent articles dealing with ganciclovir therapy in neonates. References from selected articles as well as from reviews were screened for additional relevant articles. In total, 13 case reports (16 patients in all), three descriptive uncontrolled studies (20 patients in all), two randomized dose-comparative studies (54 patients in all) and one randomized controlled study (42 patients) were identified.

Observations

All reported patients presented with central nervous system manifestation of CMV infection. Only the randomized controlled study showed a reduction of hearing deterioration in the treated group. Published predictors of hearing loss in congenitally CMV infected children allow identification of candidates that might benefit from treatment. Studies so far are promising but of insufficient number to make evidence based recommendations about indications for treatment of congenital CMV. As such, studies are very difficult to conduct and treatment of infants at high risk of hearing loss may appear justified. There is scientific data to help clinicians in selecting a subgroup of infants that is at higher risk of hearing deterioration and therefore might benefit the most from ganciclovir therapy.

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Abbreviations

BERA:

Brainstem evoked response audiometry

CMV:

Cytomegalovirus

CASG:

Collaborative antiviral study group

CI:

Confidence interval

CNS:

Central nervous system

CT:

Computerized tomography

OR:

Odds ratio

SNHL:

Sensorineural hearing loss

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Author information

Authors and Affiliations

  1. Neonatal Intensive Care Unit, Ghent University Hospital, De Pintelaan 185, 9000, Ghent, Belgium

    Koenraad Smets & Kris De Coen

  2. Department of Otorhinolaryngology, Ghent University Hospital, Ghent, Belgium

    Ingeborg Dhooge

  3. Medical Pedagogic Institute Spermalie, Bruges, Belgium

    Lieve Standaert

  4. Neonatal Intensive Care Unit, University Hospital of Antwerp, Edegem, Belgium

    Sabrina Laroche & Ludo Mahieu

  5. Department of Pediatrics, City Hospital, Roeselare, Belgium

    Noël Logghe

  6. Neonatal Intensive Care Unit, University Hospital Leuven, Leuven, Belgium

    Veerle Cossey

  7. Department of Otorhinolaryngology, University Hospital of Antwerp, Edegem, Belgium

    An Boudewyns

Authors
  1. Koenraad Smets
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  2. Kris De Coen
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  3. Ingeborg Dhooge
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  4. Lieve Standaert
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  5. Sabrina Laroche
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  6. Ludo Mahieu
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  7. Noël Logghe
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  8. Veerle Cossey
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  9. An Boudewyns
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Corresponding author

Correspondence to Koenraad Smets.

Additional information

Prepared for the Flemish Society of Pediatrics’ Neonatology and Perinatal Epidemiology Working Group: Aerssens Peter, MD, department of Pediatrics, Virga Jesse Hospital, Hasselt, Belgium; Casaer Alexandra, MD, Neonatal Intensive Care Unit, St Jan Hospital, Bruges, Belgium; Cools Filip, MD, Neonatal Intensive Care Unit, Free University of Brussels, Brussels Belgium; Deloof Els, MD, department of Pediatrics, Heilig-Hart Hospital, Leuven, Belgium; Jeannin Philippe, MD, department of Pediatrics, Jan Palfijn Hospital, Gent, Belgium; Naulaers Gunnar, MD, PhD, Neonatal Intensive Care Unit, University Hospital Leuven, Leuven, Belgium; Peirens Geertrui, MD, Child & Family, Hasselt, Belgium; Schatteman Isabelle, MD, department of Otorhinolaryngology, St Augustinus Hospital, Wilrijk, Belgium; Van Laer Paul, MD, Namen, Belgium; Van Mol Christine, MD, Neonatal Intensive Care Unit, St Augustinus Hospital, Wilrijk, Belgium

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Smets, K., De Coen, K., Dhooge, I. et al. Selecting neonates with congenital cytomegalovirus infection for ganciclovir therapy. Eur J Pediatr 165, 885–890 (2006). https://doi.org/10.1007/s00431-006-0192-2

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  • DOI: https://doi.org/10.1007/s00431-006-0192-2

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