Treatment of symptomatic congenital cytomegalovirus infection with valganciclovir.

Abstract:

:Cytomegalovirus (CMV) is the most common cause of congenital infection in humans. Some congenitally infected infants will develop sequelae later in life, especially sensorineural hearing loss (SNHL) and mental retardation. There is no generally accepted antiviral therapy for the treatment of symptomatic congenital CMV infections yet. We present a neonate with symptomatic congenital CMV infection, who was treated with intravenous (iv) ganciclovir (GCV) during 18 days and subsequently with oral valganciclovir (VGCV) for 5.5 months, in an attempt to prevent development of SNHL. GCV was given intravenously 10 mg/kg/day in two doses and VGCV doses ranged from 280-850 mg/m2 bidaily (bid). Our experience shows that it is not possible to give a fixed dosing regime for VGCV in neonates and that continuous adaptation of dose is necessary to achieve stable target levels of GCV and to keep the viral load in urine at undetectable level. At 18 months of age no hearing deterioration has occurred. While the current findings are encouraging, the limitations of a single case report with a relatively short follow-up emphasizes the need for further prospective randomized studies to evaluate pharmacokinetics, efficacy and safety of VGCV therapy in neonates with congenital CMV infection.

journal_name

J Perinat Med

authors

Meine Jansen CF,Toet MC,Rademaker CM,Ververs TF,Gerards LJ,van Loon AM

doi

10.1515/JPM.2005.065

keywords:

subject

Has Abstract

pub_date

2005-01-01 00:00:00

pages

364-6

issue

4

eissn

0300-5577

issn

1619-3997

journal_volume

33

pub_type

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