The Relationship Between Cytomegalovirus Specific Immunoglobulin M (IgM) Levels with dB Wave V Auditory Brainstem Response in Congenital Cytomegalovirus Infection

Cytomegalovirus (CMV) infection in humans usually involves a complex balance between viruses and hosts, which results in persistent and dormant infections. CMV in humans encodes various types of protein genes that can affect the activation of host cells, leukocytes, inflammatory responses, as well as active and passive immunity defenses that causes persistent infection of CMV in Received: July 24, 2019

the human body [1]. Women with primary CMV infection during pregnancy have a greater risk of giving birth to children with congenital CMV infection, which has an incidence of around 40%.

Autopsy studies of fetuses and newborns with congenital infections
show that CMV infects various types of cells and causes damage to organs, including defects in the cochlea, vestibular, and auditory canal causing hearing loss in infants [2]. Some population-based research in Sweden, America and Canada reported that between 9.3-17% of newborns with congenital CMV (cCMV) infection will suffer from sensorineural hearing loss (SNHL). The incidence of SNHL is 22-41% in infants with clinical symptoms, and 6-16% in infants who are asymptomatic or have subclinical symptoms [2,3].
The Immune assay enzyme is often used to detect IgG and IgM CMV. IgG serum can be used to determine the history of previous CMV infections, namely for knowing the risk of viral (blood and organ donor) transmission, and the risk of reactivation in immunocompromised patients. IgM serum is used to determine the presence of primary infection in patients [4]. Otoacoustic Emission (OAE) procedure is an examination option that can be done for the purpose of screening cochlear function. The Auditory Brainstem Response (ABR) can be tested as an auditory nerve function test [5]. This study aimed to determine the relationship between the dB emergence of the V wave in the ABR examination results and Cytomegalovirus specific immunoglobulin M (IgM) levels in patients with congenital Cytomegalovirus infection.

Methods
This study used a cross-sectional study design. The study was

Discussion
The sex of the subject in this present study was 31 (66%) male subjects, and 16 (34%) female subjects. There were considerably more male subjects than female subjects, with almost 2:1 ratio.
Other studies showed no statistically significant differences in the incidence of congenital Cytomegalovirus infection by sex [6].  [13]. Some research was unable to define the timing of virus transmission to the fetus which limits any definitive interpretation of these studies.

The literature suggests that the role of viral load measurements
in predicting CMV-associated SNHL is unclear at the present time Primary CMV infections are associated with the greatest risk of in-utero transmission with incidence ranging from 30-35%, while for non-primary infections the transmission rate is significantly lower at 1.1-1.7% [15]. There is no pathognomonic configuration of hearing loss caused by cCMV. Rather, it is characterized by its unstable nature, with rapid progression and fluctuations [16]. One study reported that an additional 900 infants with asymptomatic cCMV infection are estimated to have SNHL within 8 weeks of life, although nearly half of these infants are likely missed by NHS [17].
In this present study, the correlation coefficient (r) that was found in the result of the right ear was 0.57, which means the The second factor involves a disruption in the hair cell which is associated with an infection in the cochlea, while the latter is an immune response to the congenital infection.  In developing nations with highly seropositive populations, prevalence ranges between 1% and 6%. This correlation is explained by the fact that cCMV birth prevalence increases with maternal seroprevalence [17]. Schachtele

Conclusion
Based on the results of this study, it can be concluded that there is a strong correlation between dB V wave appearance from ABR examination with Cytomegalovirus-specific levels of immunoglobulin M (IgM) in patients with congenital Cytomegalovirus infection.