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A survey of 8080 subjects was conducted in Baltimore, examining the association between infection with hantaviruses and renal disease. Two groups (N = 6060) with no known risk factors were selected to establish a baseline antibody prevalence. Overall, antibody prevalence was 0.25%. Seroprevalence increased with age, without sex- or race-related differences. Patients with proteinuria showed the same patterns of infection but were more commonly seropositive (1.46%) than the reference group( OR, 3.23; P < .05). Infection among dialysis patients with end-stage renal disease was 2.76%, significantly higher than in the reference group( OR, 5.03; P < .05). In the proteinuria and the dialysis groups, hantavirus infection was consistently associated with a diagnosis of hypertensive renal disease. The association was unrelated to other chronic renal disease diagnoses. Overall, 6.5% of patients with end-stage renal disease due to hypertension were seropositive for a hantavirus. These data suggest that hantavirus infection is associated with hypertensive renal disease.