HearS-cCMV: pilot feasibility and cost-effectiveness of targeted congenital cytomegalovirus screening

Dr Valerie Sung1,2,3, Professor Cheryl Jones4,2,1,3, On behalf of HearS-cCMV

1Murdoch Children’s Research Institute, Parkville, Australia,

2University of Melbourne, Department of Paediatrics, Parkville, Australia,

3The Royal Children’s Hospital, Parkville, Australia,

4Melbourne Academic Centre for Health (MACH), Parkville, Australia

 

Purpose of presentation

To outline the protocol for a pilot screening program for congenital cytomegalovirus (cCMV) through universal hearing screening in Victoria, Australia.

Nature and scope of topic

The HearS-cCMV pilot project aims to investigate the feasibility and cost-effectiveness of targeted salivary cCMV screening for infants within Victorian maternity hospitals. It also aims to assess if a positive cCMV screen enables expedited audiological confirmation and assessment by a Paediatric Infectious Disease specialist, and the timely initiation of antiviral treatment, if appropriate.

The primary objective is to determine the feasibility of early salivary cCMV screening as measured by the infants who complete a salivary cCMV screening test prior to or at 21 days of age as a proportion of those who receive a ‘refer’ result on the second newborn hearing screen.

Issue or problem under consideration

Congenital CMV infection is the leading non-genetic cause of sensorineural hearing loss (SNHL) and a potentially treatable condition. Two recent trials have shown antiviral therapy for symptomatic cCMV within one month after birth to reduce SNHL progression and improve neurodevelopmental outcomes. However, the hearing and developmental trajectories of treating CMV positive infants with isolated SNHL is not known.

HearS-cCMV will be piloted through the Victorian Infant Hearing Screening Program (VIHSP) in four Victorian maternity hospitals. Its results will inform the feasibility and cost-effectiveness of rolling the program across the state, and provide a mechanism to diagnose cCMV early enough to offer potentially effective treatment and improve hearing and neurodevelopmental outcomes.

Outcome or conclusion reached

HearS-cCMV is starting in early 2019.


Biography:

Valerie is a paediatrician at Melbourne’s Royal Children’s Hospital, NHMRC Early Career Fellow at the Murdoch Children’s Research Institute and Senior Honorary Fellow at the University of Melbourne Department of Paediatrics. She leads a clinical and research program on childhood hearing loss. Her research aims to capture population-level outcomes of universal hearing screening for the full spectrum of hearing loss, optimise childhood hearing loss management, in particular mild losses, and identify treatments to potentially reverse hearing loss progression. She founded CHAMP, a group of Australasian paediatric specialists, to optimise medical management of childhood hearing loss.

About ANHSC

The Australasian Newborn Hearing Screening Committee aims to foster the establishment, maintenance and evaluation of high quality screening programs for the early detection of permanent childhood hearing impairment throughout Australia and New Zealand.

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