treatment

Last edited 06/2021 and last reviewed 10/2021

• antiviral therapy
  • treatment with a six month course of valganciclovir starting in the first month of life has been associated with improved hearing and developmental outcomes at 24 months (1)
    • owing to the risk of associated toxicities, particularly neutropenia, expert guidance recommend valganciclovir treatment for infants with symptomatic disease and those with isolated sensorineural hearing loss, but not for asymptomatic infants
  • infants should be monitored for toxicities by a paediatric infectious disease specialist throughout the treatment course
    
    
• hearing surveillance
  • serial audiological evaluations
    • starting at baseline and continuing every 3-6 months until 3 years, and then annually until 6 years - are recommended because of the high risk of hearing deterioration in this period.
    • others recommend continuing routine audiological evaluations through adolescence (1)
  • hearing amplification and early access to oral or sign language
    • can improve educational and communication outcomes in children with hearing loss
      
      
• vision surveillance
  • refer infants with cCMV for an ophthalmologic evaluation at diagnosis followed by yearly surveillance until age 5 in those with symptomatic disease
  • delayed onset chorioretinal sequelae are rare

Reference:

1. Pesch MH et al. Congenital cytomegalovirus infection.BMJ 2021;373:n1212 | doi: 10.1136/bmj.n1212