PREVALENCE OF HANTA VIRUS-ANTIBODIES IN P ATIENTS WITH ACUTE OR CHRONIC RENAL DISORDERS AS WELL AS WITH VASCULITIS

During the last years Hanta virus infections have gained an increasing clinical importance in Germany. This infection is endemic in some geo graphic areas and acute renal failure may occur during this infection. Therefore, we were interested in the question whether a previously no r recognized Hanta virus infection with non-resolving acute renal fail ure could be a cause of end-stage renal disease. As Hanta virus antibo dies persist at least for several years after an infection we screened sera from appropriate patients with end-stage renal disease (ESRD) us ing a sensitive indirect immunofluorescence assay. This test detects H anta virus antibodies of both the IgG and IgM class. Among the 3 diffe rent groups of ESRD patients (108 patients from an urban region, 80 pa tients from the country side and 90 patients after successful kidney t ransplantation), Hanta virus antibodies were detected in 1 individual of each group which equals a prevalence of about 1%. These data are in accordance with the antibody prevalence known for Germany. Furthermor e, out of 32 patients from the Southern part of Bavaria with establish ed acute renal failure (surgical patients not included) only 1 had a l ow Hanta virus titer. This strongly supports the hypothesis that Hanta virus infections are not endemic in our area and are rarely the cause of acute renal failure. Surprisingly, our of 26 patients with proven vasculitis (Wegener's granulomatosis or microscopic polyarteritis) 4 s howed a significant Hanta virus titer (15%). The presence of Hanta vir us antibodies may simply be an epiphenomenon of the systemic vasculiti s. However, there is increasing evidence that bacterial and viral infe ctions may be the initiating event in triggering a systemic vasculitis .