1190. Burden of Congenital Cytomegalovirus Among Newborns/Infants &lt; 2 Years of Age From 2010 to 2020
Authors: Fowler Karen , Mucha Jacek , Monika Neumann , Lewandowski Witold , Kaczanowska Magdalena , Schmidt Elvira , Natenshon Andrew , Talarico Carla , Buck Philip , Diaz-Decaro John D 
Published: December 2021

Abstract

Background
Congenital cytomegalovirus (cCMV) is a leading cause of preventable congenital birth defects worldwide. In the United States, approximately 1 in 200 infants are born with cCMV and about 10% exhibit symptoms at birth; of those, 40-60% experience long-term sequelae including sensorineural hearing loss and developmental delays. As routine newborn surveillance is universally absent, it is difficult to assess the absolute burden of cCMV and demonstrate the need for CMV treatment and prevention. Here we describe the global epidemiologic burden of cCMV from 2010-2020 by performing a systematic review of the literature.

Methods
Publications from 2000-2020 on CMV-related epidemiologic, economic, and humanistic burden across all ages were identified using Medline, Embase, and LILACS. Epidemiologic burden estimates of cCMV in at-risk age groups (newborns [≤ 1 month] and infants [2 months to 2 years]) were extracted from recent studies published from 2010-2020, excluding previous systematic literature reviews, chart reviews, case series, gray literature, and studies in immunosuppressed populations. The primary outcome measure was seroprevalence, defined by CMV-specific immunoglobulin G titer or confirmed by CMV polymerase chain reaction in saliva or urinary samples.

Results
Of 8970 records on CMV epidemiologic burden across all ages, 3600 were screened (Fig. 1). Records were excluded based on study population, outcome, design, or other reason, yielding 157 articles; 24 reported cCMV infection in newborns/infants in 13 countries (Fig. 2). cCMV seroprevalence estimates differed based on type of screening (Fig. 3). cCMV seroprevalence ranged from 0.28-67.2% among publications reporting on universal screening (n=6), 0.6-29.2% among publications reporting on targeted screening (n=17) based on hearing loss, low birth weight, or small for gestational age, and 36.0% in one publication reporting on prenatal screening.
Figure 1. Study selection for epidemiological burden

cCMV, congenital cytomegalovirus
Figure 2. Global map of the location and number of included studies

Figure 3. cCMV seroprevalence and 95% confidence interval* by universal, targeted, and prenatal screening methods

*Confidence intervals shown when available. cCMV, congenital cytomegalovirus

Conclusion
There is a worldwide lack of cCMV epidemiologic data with heterogeneity in seroprevalence, influenced by inconsistent and varied screening efforts. Implementation of consistent screening methods is essential to accurately describe the burden of cCMV, justify future vaccine (or other prevention or treatment) introduction, and measure impact.

Disclosures
Jacek Mucha, MS, Certara (Employee) Neumann Monika, Information Specialist, Certara (Employee) Witold Lewandowski, MD, BA, Certara (Other Financial or Material Support, Former employee during abstract development)Tata Consultancy Services (Employee) Magdalena Kaczanowska, MPH, Certara (Employee) Elvira Schmidt, MSc, Certara (Employee) Andrew Natenshon, MA, Moderna, Inc. (Employee) Carla Talarico, MPH, PhD, Moderna, Inc. (Employee) Philip Buck, MPH, PhD, Moderna, Inc. (Employee) John D. Diaz-Decaro, MS, PhD, Moderna, Inc. (Employee)