INCREASED PREVALENCE OF HCV ANTIBODIES IN DIALYZED ASHKENAZI JEWS - APOSSIBLE ETHNIC PREDISPOSITION

Background. The prevalence of hepatitis C (HCV) antibodies in dialysis patients is considerably higher than that found among healthy blood d onors. This increased seroprevalence has been correlated to increased duration of dialysis, mode of dialysis and to the number of blood tran sfusions administered. However, factors other than nosocomial ones als o seem to play a part in disease transmission. The role of the patient 's ethnic origin, possibly reflecting on his/her genetic makeup has re ceived scant attention. In this study, HCV seroprevalence in our dialy sis population, which consists of three major ethnic subgroups (Ashken azi Jews, Sephardi Jews and Arabs), was examined. Methods and results. Altogether HCV seropositivity was determined in 120 dialysed patients -65 males/55 females (76 hemodialysis, 44 CAPD), using second generati on ELISA confirmed by RIBA-2. Mean age was 59.7 +/- 15.7 (range 16-86 years). Patients had to have been on dialysis for a minimum of 3 month s (mean duration 45.2 +/- 44.5 months). Patients whose end-stage renal disease was due to diabetic nephropathy (DN) or those who had previou sly been transplanted (TP) were considered as separate groups and comp ared to the group as a whole. Of the 120 patients, there were 49 Ashke nazi Jews (40.8%), 57 Sephardi Jews (47.5%) and 14 Arabs (11.7%). Over all HCV prevalence was 21.7% (26/120) with a significantly greater pre valence in HD compared to CAPD (30.3 vs. 6.8%, P < 0.01). Respective v alues for Ashkenazi Jews, Sephardi Jews and Arabs were 30.6, 15.8, and 14.3% (P < 0.01, Ashkenazi Jews vs. Sephardi Jews and Arabs). DN had a lower 3.7% while TP had a higher 46.1% prevalence compared to the gr oup as a whole (P < 0.01). In general, the increased frequency of anti HCV antibodies was significantly correlated to the duration of dialys is and the number of blood transfusions administered. This, however, w as not the case in the greater prevalence of HCV found in Ashkenazi Je ws compared to Sephardi Jews and Arabs which was independent of the ab ove factors and the mode of dialysis. Conclusion. Our results showing increased HCV sero-positivity in Ashkenazi Jews compared to Sephardi J ews and Arabs, suggest that ethnic factors might predispose to HCV tra nsmission and infectivity.