Recommendations for Monitoring and Follow-Up in Children Being Treated for Congenital Cytomegalovirus31,48
| Monitoring | Follow-Up |
|---|---|
| Absolute neutrophil counts weekly for first 6 weeks, at week 8, and then monthly for the duration of therapy | 1. Ophthalmic examination early in the course of treatment, with follow-up examinations as recommended by the ophthalmologist |
| Transaminases monthly | 2. Audiologic testing at 6-month intervals for the first 3 years of life and annually thereafter through adolescence |
| 3. Developmental assessments beginning at the first year of life on a case-by-case basis | |
| Consider therapeutic drug monitoring if viral load increases >1.0 log10 during treatment, if toxicity is suspected, or if the | 1. Hearing every 3-6 months in the first year, every 6 months until 3 years of age, and every 12 months until 6 years of age |
| patient has an increased risk of toxicity (eg, prematurity, abnormal renal function). | 2. Pediatric infectious disease annual visits until at least 2 years of age |
| Not evidence-based, and not consensus: Consider viral load every 2-4 weeks while on therapy. | 3. Neurodevelopmental assessment at 1 year of age in a child development service |
| 4. Ophthalmic assessment directed by ophthalmologist but at a minimum, a baseline review and annually up to 5 years of age |