Hearing loss has been shown to be reduced or prevented with 6-week courses of intravenous ganciclovir or oral valganciclovir,6with roughly 84% of children having either maintained or improved their hearing throughout the 6 months following treatment.3
Of children treated with either regimen, 21% will continue to experience deterioration in hearing, compared with 68% of those not treated.3In a retrospective study of children with asymptomatic cCMV and normal hearing at baseline, reduced rates of hearing loss were seen in those who underwent 6 weeks of intravenous therapy followed by 1 year of oral therapy.6
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Parents should be cautioned, however, that the risk of neutropenia associated with these medications is roughly 63% for intravenous ganciclovir and 38% for oral valganciclovir, and can be severe enough to warrant discontinuation of treatment.6This side effect, however, does resolve with cessation of treatment.
Antiviral therapy should be initiated in infants born with evidence of central nervous system involvement and hearing loss, and should be strongly considered for newborns with end-organ disease such as hepatitis, thrombocytopenia, and pneumonia.3
