Why does the HbS antigen affect the Rh genotype

(Dear Og I had a moment of shear stupidity, read on)

In my blood tranfusion service lab I’ve begun to notice a trend that has me confused. Whenever we needed to get phenotypically matched red blood cells for sickle cell disease patients they always tend to be D(+) C(-) c(+) E(-) e(+) [R0r]. This is odd because the when I search our blood supply we rarely have blood products that are Rh positive and C(-) E(-). So usually we’ll just start searching for Rh negative units, of which 14% the majority are C(-) and E(-).

Here is an excerpt of from an report in the medical journal Transfusion:

I realize that the Rh antigens and the HbS antigens are both on the membrane of the red blood cell, but I don’t understand genetically what links them. Why is sickle cell disease so commonly linked with this rarer phenotype in our general red blood cell inventory? Does anyone know if having sickle cell disease affects other red cell membrane antigens?

Whoops this thread was an accidental submission when there was a short time out, someone please flag for removal!

See this question.