HIGH-FREQUENCY OF ANTIBODIES TO HANTAAN VIRUS AND HEPATITIS-C VIRUS IN CHRONIC-HEMODIALYSIS PATIENTS - COINCIDENCE OR CROSS-REACTION

Objectives. To address the question of whether there is any coincidenc e or cross-reaction between hepatitis C virus (HCV) and Hantaan virus (both RNA arboviruses), as well as to assess the frequency of antibodi es to the above viruses amongst chronic haemodialysis patients in our region. Design. Collection of serum samples from consecutive unselecte d chronic haemodialysis patients. Setting. A tertiary referral center (University Hospital). Subjects. One hundred and fourteen chronic haem odialysis patients were investigated for the presence of antibodies to HCV (anti-HCV) and Hantaan virus disease (anti-HVD). Eleven unselecte d non-haemodialysis patients with well-defined haemorrhagic fever with renal syndrome (HFRS) were also investigated for the anti-HCV antibod ies comprising the disease control group. Interventions. None. Main ou tcome measures. The utility of an anti-HVD positive test in chronic ha emodialysis patients. Results. Seventeen patients (14.9% 95% confidenc e interval [CI] 8.4-21.4%) were anti-HCV positive, whereas 15 (13.2%, 95% CI 6.9-19.3%) were anti-HVD positive. An anti-HCV positive test wa s confirmed by recombinant immunoblot assay (RIBA II) in 88.2%. The pr esence of anti-HCV antibodies was not associated with transfusions but with the longer duration of haemodialysis (62.8 +/- 29.8 vs. 31.2 +/- 29.3 months, P < 0.001). Anti-HVD antibodies were not associated with transfusions or with the duration of haemodialysis. Three patients we re positive for both anti-HCV and anti-HVD antibodies. None of the 11 patients with well-defined HFRS had anti-HCV antibodies. Conclusions. Chronic haemodialysis patients are a high risk group for HCV infection in association with the duration of haemodialysis and, at least for o ur geographical area, these patients have to be examined for anti-HVD antibodies especially when a definite causative agent for chronic rena l failure is not found. The HVD and HCV infection are not exceptional amongst haemodialysis patients in our region, whereas the possibility of a cross-reaction between these two RNA arboviruses is rather exclud ed as there was no evidence of HCV infection amongst the patients with well-defined HFRS.