2023 Early Hearing Detection & Intervention Conference
March 5-7, 2023 • Cincinnati, OH
9/24/2018 | 10:30 AM - 11:00 AM | Clinical Sequelae in Patients Receiving Valganciclovir and/or Ganciclovir Therapy for Congenital Cytomegalovirus (cCMV) | Diamond Ballroom II
Clinical Sequelae in Patients Receiving Valganciclovir and/or Ganciclovir Therapy for Congenital Cytomegalovirus (cCMV)
Congential CMV is the leading cause of sensorineural hearing loss in the developed world. Research has shown a 6-month course of valganciclovir or ganciclovir treatment in cCMV improves long-term hearing and developmental outcomes. Although well studied in term infants, there is limited information about the side effect profile associated with treatment in premature infants.
This study aims to identify the side effects seen with use of valganciclovir and/or ganciclovir in cCMV.
The EMR at the UofMN Children’s Hospital was queried to identify neonatal patients between 2006-2016 with positive urine or serum CMV admitted to the NICU. Chart review was performed to identify patients with cCMV. cCMV was defined as a positive CMV result within the first 21 days of life.
15 patients in the NICU were treated with valganciclovir and/or ganciclovir for cCMV. Five patients were born at term and ten patients were preterm. The average gestational age at birth was 33 weeks with a range of 24 weeks to 39 weeks. Of the 15 patients, 80% experienced neutropenia during treatment, defined as an absolute neutrophil count less than 1500. Twenty-seven percent of all patients required a pause in treatment due to neutropenia and 13% experienced a serious infection during treatment. Of the 10 preterm infants, 90% experienced neutropenia during treatment. In preterm infants with neutropenia, 78% required G-CSF. 40% of preterms required a pause in therapy due to neutropenia and 20% experienced a serious bacterial infection during treatment.
While treatment has improved long-term audiological outcomes in studies, it is important to understand the side effects of long-term therapy for cCMV, particularly neutropenia. This consequence may be of particular significance in preterm infants with immature immune systems and high risk for secondary infections. We need to understand the complex pharmacokinetics of these drugs when used for preterm infants.
- Understand the potential side effects of therapy for congenital CMV
- Understand the unique challenges of treatment in the preterm infant
- Understand goals for future studies to better guide cCMV drug therapy
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Presenters/Authors
Ashley Phimister
(), phimi002@umn.edu;
Pediatric Resident
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Catherine Koozer
(), ckoozer@umn.edu;
Pediatric Resident
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Heidi Moline
(), hmoline@umn.edu;
Pediatric Resident
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Erin Osterholm
(), oste0123@umn.edu;
Dr. Osterholm is Assistant Professor of Pediatrics at the University of Minnesota in Neonatology. She is interested in the clinical implications of CMV on neurodevelopment in both preterm and term infants.
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