125. Longitudinal salivary Cytomegalovirus shedding in a cohort of infants with congenital CMV infection
Session: Oral Abstract Session: Potpourri of Pediatric Infections
Thursday, October 3, 2013: 10:30 AM
Room: The Moscone Center: 250-262
Background:

Cytomegalovirus (CMV) is the leading non-genetic cause of sensorineural hearing loss (SNHL). Children with congenital CMV infection excrete CMV for a variable time period during childhood. It has been suggested that shorter duration of shedding in urine was associated with SNHL but this association remains to be confirmed.  Most studies to date have examined CMV excretion patterns in urine. The objective of this study was to examine duration and the amount of salivary CMV shedding by PCR in a large cohort of children with congenital CMV infection. 

Methods: As part of an ongoing multicenter study (CHIMES study), infants born at seven hospitals in the U.S. were screened for congenital CMV infection. Saliva specimens collected at newborn screening, at enrollment into the follow-up study (3-6 wks), and at every 6 months up to 48 months of age were tested for CMV using real-time PCR. All CMV-infected infants underwent audiologic evaluation in early infancy. 

Results:

Of the CMV-infected children, 102 children had virus shedding data at all follow-up visits up to 24 months of age and were included. Twenty three infants treated with gancyclovir/valgancyclovir were excluded. The cohort included 12 infants with SNHL at birth. The median duration of CMV shedding in saliva in the study subjects was 24±9.8 months. There was no significant difference in the duration of shedding for infants with and without hearing loss at birth (p = 1). There was no significant difference between viral load at birth (1.23x107 vs. 2.2x106 copies/ml) and at 24 months (4.78x102 vs. 4x102 copies/ml) between infants with and without hearing loss.  Among infants with saliva PCR data available at 36 and 48 months, 54/109 (49.5%) tested positive by PCR at 36 months and 22/74 (29.7%) infants were positive at 48 months. 

Conclusion:

Most infants with congenital CMV infection shed CMV in saliva for a median of two years after birth. There is no significant difference between duration of shedding of CMV between infants with and without SNHL at birth. There was also no significant difference in saliva viral load at birth and at 24 months of age between children with and without SNHL. 

Swetha G. Pinninti, MD1, Shannon Ross, MD1, April Palmer, MD2, Amina Ahmed, MD3, Robert W. Tolan Jr., MD4, David I. Bernstein, MD, MA5, Marian Michaels, MD, MPH6, Pablo J. Sanchez, MD, FIDSA7, Karen Fowler, DrPH1 and Suresh Boppana, MD, FIDSA1, (1)Pediatrics, University of Alabama at Birmingham, Birmingham, AL, (2)Pediatrics, University of Mississippi Medical Center, Jackson, MS, (3)Carolinas Medical Center, Charlotte, NC, (4)Pediatrics, The Children's Hospital at Saint Peter's University Hospital, New Brunswick, NJ, (5)Cincinnati Children's Hospital Medical Center, University of Cincinnati, Cincinnati, OH, (6)Pediatric Infectious Diseases, Children's Hospital of Pittsburgh, Pittsburgh, PA, (7)University of Texas Southwestern Medical Center, Dallas, TX

Disclosures:

S. G. Pinninti, None

S. Ross, None

A. Palmer, None

A. Ahmed, None

R. W. Tolan Jr., None

D. I. Bernstein, None

M. Michaels, None

P. J. Sanchez, NIH: Grant Investigator, Research grant
Abvie: Scientific Advisor, Speaker honorarium
Glaxo-Smith-Kline: Grant Investigator, Research grant

K. Fowler, None

S. Boppana, None

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