Do targeted newborn screening and early antiviral therapy prevent sensorineural hearing loss due to congenital cytomegalovirus infection (cCMV)?

Project Details

Background

cCMV is believed to account for 15-20% of bilateral moderate to profound sensorineural hearing loss (SNHL), and can cause multi-organ failure, poor growth and neurodevelopmental sequelae. International studies suggest approximately 0.6 % of live births are infected with cCMV. Two recent RCTs have shown antiviral therapy for symptomatic cCMV within one month after birth to reduce SNHL progression and improve neurodevelopmental outcomes. However, these trial results only apply to infants with severe brain involvement with cCMV, and not isolated SNHL, with early institution of antiviral therapy. We need to develop mechanisms to provide expedited newborn screening of infants for cCMV and enable recruitment of infants with hearing loss and cCMV into clinical trials of antiviral therapy.

Aims

1. To determine the feasibility and cost effectiveness of targeted newborn screening for cCMV screening in Victoria,
2. To determine the prevalence and natural progression of SNHL and development in Australian children with cCMV (using Victorian longitudinal cohorts), and
3. To develop a framework for evaluation of the benefit and harms of early antiviral therapy for cCMV in infants with SNHL in Australia.

Methods

1. Aim 1: Feasibility and cost-effectiveness study of salivary swab PCR testing followed by antiviral treatment if cCMV positive in newborn infants referred with two failed hearing screens.
2. Aim 2: Longitudinal cohort of infants with cCMV referred to audiology after two failed hearingscreens, based on Aim 1.
3. Aim 3: Development of an appropriate framework or trial to evaluate benefits and harms of early antiviral therapy for cCMV in infants with SNHL.

A PhD scholarship is available to the successful applicant.