Blood genome expression Profiles in Infants with Congenital Cytomegalovirus Infection: Is the asymptomatic infant truly asymptomatic?

Background: Congenital cytomegalovirus (cCMV) infection represents the most frequent non-genetic cause of sensorineural hearing loss (SNHL). The disease spectrum varies from clinically apparent (“symptomatic”) to clinically inapparent (“asymptomatic”). Analysis of host genome expression profiles has provided new insights into disease pathogenesis and assessment of clinical severity. Its value as a biomarker in infants with cCMV has not been explored. Methods: Infants with cCMV infection, both symptomatic and asymptomatic, were enrolled at a median age of 17 days of age and followed up for 3 years to assess the development of SNHL. Healthy age matched controls were also enrolled as a reference. Blood samples were obtained at enrollment and follow-up to assess host responses by RNA transcriptional profiling. Symptomatic CMV was defined as the presence of any clinical, laboratory, ophthalmologic, audiologic or neuroimaging abnormalities. 158 total samples; 56 Asymptomatic; 92 Symptomatic; 10 Control