654. Cytomegalovirus shedding in saliva and hearing loss in congenital CMV infection
Session: Poster Abstract Session: Oh, Those Pesky Viruses!
Thursday, October 27, 2016
Room: Poster Hall
Background: Children with congenital CMV (cCMV) infection shed virus for prolonged but variable duration during childhood. The association between CMV salivary shedding and clinical outcome is not known. The aim of this study is to determine the duration of CMV shedding in saliva in children with cCMV infection and the association between the length of shedding with symptoms at birth and hearing outcome.

Methods: cCMV infants were enrolled in the CMV and Hearing Multicenter Screening (CHIMES) study. Infants with confirmed cCMV were followed for hearing outcome and saliva samples were collected at newborn screening, enrollment (3-6 weeks) and every 6 months up to 48 months. Age appropriate hearing testing was performed at each visit. Only children with ≥4 study visits were included in this analysis. Samples were tested by real-time PCR. Duration of shedding was compared between groups using a t-test.

Results: 197 infants with ≥4 visits after enrollment constituted the study population. Mean duration follow up was 44 months and the mean duration of salivary shedding 18.2 months (± 11 months). There was no difference in length of saliva viral shedding between infants with symptomatic infection (n=14, mean shedding 17 mo. ± 10 mo) and those with asymptomatic infection (n=183, mean shedding 18.3 mo. ± 11 mo, p=0.668). Twenty-four children had SNHL and the duration of shedding was not different between those with hearing loss and normal hearing (15.9mo vs 18.6mo, p=0.258). Similarly, there was no difference in length of saliva shedding of CMV in children with delayed-onset or progressive hearing loss (mean 16.2 mo. ± 11.8 mo) and those with normal hearing (mean 18.6 mo. ± 10.8 mo, p=0.352).

Conclusion: Children with congenital CMV infection shed virus from their saliva a mean of 18 months. There was no significant difference in duration of CMV shedding between infants with and without symptomatic infection at birth nor infants with and without hearing loss at birth. Saliva shedding is not associated with progression of hearing or delayed-onset hearing loss. This data suggests that peripheral viral shedding is a poor marker for inner ear pathology in children with congenital CMV.

Sunil Pati, PhD, MBA1, Zdenek Novak, MD1, Suresh Boppana, MD, FIDSA, FPIDS1, Karen Fowler, DrPH2 and Shannon Ross, MD, MSPH, FIDSA, FPIDS1, (1)Pediatrics, University of Alabama at Birmingham, Birmingham, AL, (2)Division of Pediatric Infectious Diseases, University of Alabama at Birmingham, Birmingham, AL


S. Pati, None

Z. Novak, None

S. Boppana, None

K. Fowler, None

S. Ross, None

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