A systematic review of the incidence of sensorineural hearing loss in neonates exposed to Herpes simplex virus (HSV)

Objective: To develop evidence-based guidelines for appropriate audiological monitoring of children born following exposure to or infection with Herpes simplex virus (HSV) for development of immediate or delayed-onset of sensorineural hearing toss (SNHL). Data sources: A Medline search of the 1966-July 2007 database was supplemented by search of the additional database Embase (1980-July 2007). Manual. search was conducted of references of identified papers and book chapters. Study selection: Articles were sought that were longitudinal in design, to include an inception cohort of children infected with (or exposed to) HSV who were entered at a similar point at birth and followed over time with serial audiometry to identify hearing loss if it developed. Data extraction: Patient information and audiometric data extraction from relevant articles was performed independently by all three researchers. Discrepancies were resolved by mutual consensus. Data synthesis: Data was analyzed using descriptive statistics. Results: Three papers reported five children with SNHL following apparent disseminated HSV-2 infections in which other obvious clinical sequelae of HSV infection and co-morbid conditions were present. Audiometric information is tacking regarding onset and progression. There are no reports of delayed-onset SNHL following perinatal or asymptomatic HSV infection. Conclusions: The development of SNHL in children with exposure to HSV occurs rarely. Routine serological screening for HSV infection in otherwise healthy neonates newly diagnosed with SNHL is unjustified. There is insufficient data to define the incidence and natural history of SNHL in children with HSV infections. Carefully designed and conducted studies are needed to address this issue. (C) 2008 Elsevier Ireland Ltd. All rights reserved.