The Incidence of Symptomatic Congenital Cytomegalovirus (CMV) Infection in Korea; A 15-year Multi-center Study

BACKGROUND: Congenital cytomegalovirus (cCMV) infection is the major cause of sensorineural hearing loss and the most frequent viral origin of neurodevelopmental impairment. The aim of this study was to evaluate incidence and characteristics of symptomatic cCMV infection in neonates in Korea with high maternal CMV seroprevalence up to 95%. METHODS: From January 2001 to February 2015, all neonates born from 7 university hospitals were included. Symptomatic cCMV infection was diagnosed in neonates within 14 days after birth. A retrospective chart review was performed. RESULTS: For 15 years, a total of 81,229 neonates were born in the 7 centers. Forty-nine neonates were identified as symptomatic cCMV and estimated incidence was 0.06% (49/81,229). The median age at CMV detection was postnatal age 1 day (range, 0–12). Small for Gestational age (47%, 23/49) was the most frequent symptom at diagnosis followed by jaundice (16%, 8/49), petechiae (14%, 7/49), and microcephaly (12%, 6/49). Thrombocytopenia (47%, 23/49) was observed in the initial laboratory evaluation. Among 69% (34/49) of the patients with neuroimaging abnormalities, ventriculomegaly (37%, 18/49) and periventricular white matter injury (18%, 9/49) were most common. Twenty-one patients (43%) received ganciclovir or valganciclovir treatment (median 41 days; range, 2–188 days). Hearing function evaluation was performed in forty-one patients (84%, 41/49). Among them, 34% (14/41) had abnormality in the first hearing examination (median 21.5 days; range, 0–239 days). Four patients eventually received cochlear implantations. Retinitis was shown only in 4% (2/49). Overall mortality was 8% (4/49) within 30 days after birth. CONCLUSION: This study would provide the baseline information for epidemiology of symptomatic cCMV in Korean newborns. A prospective study in larger population is needed to estimate the true incidence of cCMV infection among Korean newborns and measurement of disease burden of cCMV disease in Korea is warranted. DISCLOSURES: S. R. Choi, Korean Society of Pediatric Infectious Disease: Member, Research grant; K. R. Kim, The Korean Society of Pediatric Infectious Diseases: Member, Research grant; E. Y. Cho, The Korean Society of Pediatric Infectious Diseases: Member, Research grant; Y. K. Kim, The Korean Society of Pediatric Infectious Diseases: Member, Research grant; D. S. Cho, The Korean Society of Pediatric Infectious Diseases: Member, Research grant; H. K. Cho, The Korean Society of Pediatric Infectious Diseases: Member, Research grant; S. E. Park, The Korean Society of Pediatric Infectious Diseases: Member, Research grant; H. M. Kim, The Korean Society of Pediatric Infectious Diseases: Member, Research grant; Y. J. Kim, The Korean Society of Pediatric Infectious Diseases: Member, Research grant