Hantavirus seropositivity in Israeli patients with renal failure

The hantavirus is known to cause hemorraghic fever with renal syndrome (HFRS), which is widely spread in Europe and Asia. Several reports have shown an association of hantavirus antibody titers and the occurrence of renal dysfunction. From these observations, it appears that the virus is widely distributed, and different strains prevail in various areas. In the present work we studied 81 patients with end-stage renal-failure under hemodialysis (HD) treatment, 55 with mild to moderate renal failure, and 50 healthy subjects for the presence of antibodies to Hantaan and Puumala viruses. We found that 12.3% of the hemodialysis patients and 9% of the mild to moderate renal failure patients had elevated IgG anti-body titers to Puumala virus compared with 2% of the controls. IgM antibodies to Puumala virus was principally elevated in patient with chronic renal failure (CRF) not on hemodialysis (14.5%) compared with the hemodialyzed (1.2%) and controls (0%) subjects. Hantaan virus IgG antibodies were detected in 3.7% of the HD patients, 5.5% of the CRF not on HD, and in none of the controls. IgM Hantaan antibodies were found only in the non-HD renal failure patients. None of the sera were found to contain antibodies to phospholipids or single-stranded DNA. These results emphasize the widespread nature of infection with hantaviruses and imply that elaborate testing for these serologies should be performed, especially in patients with unexplained renal failure.