Cytomegalovirus urinary excretion and long term outcome in children with congenital cytomegalovirus infection

Background. Cytomegalovirus (CMV) is the most frequent cause of congenital infection, and both symptomatic and asymptomatic infants may have long term sequelae. Children with congenital CMV infection are chronically infected and excrete CMV in the urine for prolonged periods. However, the effect of prolonged viral replication on the long term outcome of these children is u nknown. Objective. To determine whether duration of CMV excretion is associated wit h outcome at 6 years of life in symptomatic and asymptomatic congenitally i nfected children. Methods. Longitudinal cohort study. Children congenitally infected with CMV were identified at birth and followed prospectively in a study of long ter m effects of congenital CMV infection. The relationship between duration of CMV urinary excretion and growth, neurodevelopment and presence and progre ssion of sensorineural hearing loss (SNHL) at 6 years of age was determined . Results, There was no significant difference in the duration of viral urina ry excretion between children born with asymptomatic (median, 4.55 years) a nd symptomatic (median, 2.97 years) congenital CMV infection (P = 0.11). Fu rthermore there was no association between long term growth or cognitive ou tcome and duration of viral excretion. However, a significantly greater pro portion of children who excreted CMV for <4 years had SNHL and progressive SNHL compared with children with CMV excretion >4 years (P = 0.019, P = 0.0 09, respectively). Conclusions. Children congenitally infected with CMV are chronically infect ed for years, but the duration of CMV urinary excretion is not associated w ith abnormalities of growth, or neurodevelopmental deficits. However, SNHL and progressive SNHL were associated with a shorter duration of CMV excreti on.