Hepatitis C Infection in the General Population of Iran: A Systematic Review

Article Information:


Group: 2009
Subgroup: Volume 9, Issue 3, Summer
Date: September 2009
Type: Review Article
Start Page: 211
End Page: 223

Authors:

  • Seyed Moayed Alavian
  • Baqiyatallah Research Center for Gastroenterology and Liver Disease, Baqiyatallah University of Medical Sciences, Tehran, Tehran, IR.Iran
  • Masoud Ahmadzad Asl
  • Department of Clinical Researches, Nikan Health Researchers Institute, Tehran, Tehran, IR.Iran
  • Kamran Bagheri Lankarani
  • Department of Gastroenterology and Hepatology, Shiraz University of Medical Sciences, Tehran, Tehran, IR.Iran
  • Mohammad Ali Shahbabaie
  • Department of Clinical Researches, Nikan Health Researchers Institute, Tehran, Tehran, IR.Iran
  • Amir Bahrami Ahmadi
  • Tehran, Tehran, IR.Iran,
  • Ali Kabir
  • Department of Clinical Researches, Nikan Health Researchers Institute, Tehran, Tehran, IR.Iran

      Correspondence:

      Affiliation: Baqiyatallah Research Center for Gastroenterology and Liver Disease, Baqiyatallah University of Medical Sciences
      City, Province: Tehran, Tehran
      Country: IR.Iran
      Tel: +98 21 8126 2072
      Fax: +98 21 8126 2072
      E-mail: Alavian@thc.ir

Abstract:


Background and Aims: There is no overall estimate of hepatitis C infection (HCV) in Iran. We reviewed all of the published and unpublished evidence related to HCV infection in Iran in order to accurately estimate the prevalence of HCV infection in the Iranian general population to inform future health system programs.

Methods: In this systematic review, all papers, medical congresses, HCV-related reports, projects of Iranian research centers and medical universities, reports from the Deputy for Health Affairs (published or unpublished), and online theses about HCV in Iran were included. We selected descriptive and analytic cross-sectional studies and surveys related to the prevalence of HCV infection in the Iranian general population between 2001 and 2008 that have sufficiently declared objectives, proper sampling methods with identical and valid measurement instruments for all study subjects and proper analysis methods regarding sampling design and demographic adjustments. We used a survey data analysis method to estimate the national prevalence rate.

Results: From the 6,431 studies we investigated, eight eligible studies reported a prevalence of HCV infection in the general population. They were from six (out of 30) provinces, in which about 43 percent of the country's population lives. We calculated that the HCV infection prevalence rate in Iran is 0.16% (95% confidence interval [CI]: 0%-0.59%).

Conclusions: In comparison with similar studies, the prevalence of HCV infection in Iran is low. This might be a result of having prevention programs for high-risk groups and strict blood screening programs.

Keywords: Hepatitis C;Iran;Prevalence;Epidemiology

Manuscript Body:


Introduction

Hepatitis C virus (HCV) infection is a major global public health problem in both developed and developing countries (1). HCV infection is transmitted mainly by exposure to infected blood or blood products, infected medical equipment despite strict hygienic control, intravenous drug abuse, hemodialysis, and organ transplantation (2, 3). There are some studies on the prevalence of HCV infection in the Iranian population that have focused specifically on healthy blood donors. The first paper in this line of literature was published in 1994 and found the prevalence of HCV infection to be 0.3% in blood donors (2). In previous studies, the prevalence of HCV infection was reported to be between 0.08% and 1.3% of the Iranian general population and blood donors in different provinces (3-6). According to the Iranian national census of 2006, the national population of Iran was 70,495,782 persons (7).

In 2003, it was estimated that HCV infection affected nearly 170 million people worldwide (8). The rate of occurrence in some regions or among high-risk groups such as injecting drug users, Hemophilia and thalassemia patients, and patients undergoing hemodialysis may be as high as 30%-90% (9). Epidemiologic evidence of HCV is one of the main evidences for strategic prevention of chronic liver diseases.

HCV infection is detected by some laboratory methods such as enzyme-linked immunosorbant assay (ELISA), recombinant immunoblot assay (RIBA), and polymerase chain reaction (PCR). Generally ELISA is used as a screening tool, RIBA is used as a complementary test, and PCR is used as a confirmatory test. HCV antibody detection with ELISA has a low specificity and positive predictive value for low-risk groups such as blood donors and the general population (10). In one study in China, with a single ELISA test as the HCV detection method, the false negative rate was nearly 17% in HCV infectors. After adding PCR to ELISA for HCV detection, false positive results decreased (11). Assessment of predicted rate for infected patients, diagnosis and treatment of high-risk groups in the community could be achieved by most effective and preventive programs in reducing the rate of HCV infection. This, or any other effective program, needs more accurate estimates of the prevalence of HCV infection in the country.

In Iran, we do not have an overall estimate of HCV infection, and the studies that have been done on HCV prevalence are restricted to specific geographic locations or provinces.

In the present systematic review, we reviewed the papers on HCV infection in Iran in order to accurately estimate the HCV infection prevalence rate in Iran in order to help promote HCV prevention programs.

Materials and Methods

We estimated the prevalence of HCV in the Iranian general population with a comprehensive systematic review of the literature and evidence followed by integrating the data and an analysis of the findings.

 Study question

Our study population was the Iranian general population, and the outcome of interest was the presence of positive HCV antibody in blood samples of the study population, based on any of the blood tests such as ELISA or RIBA/PCR even if other laboratory tests are not identified clearly, from April 2001 to March 2008.

Search strategy

For electronic and hand searching we used "Hepatitis C", "HCV," and "Iran" (or the names of its provinces) as key words for titles and/or abstracts in a MeSH word search. We also used different text words (specifically in searching national databases) to increase the sensitivity of the search.

Electronic databases

We searched 15 electronic databases of the health and biological sciences including Google Scholar, ISI, Scopus, EMBASE, Medline, WHO, CINAHL, DOAJ, CABI, High-Wire Press, EBM Review, EMR medex, Cochrane, NLM Gateway, and  DARE. Furthermore, four Iranian databases on the medical and life sciences literature were used including Iran Medex, SID, Magiran and IranDoc. Hence, the study covered all registered and certified life sciences and medical journals at the national level.

Gray literature search

In a gray literature search, we found 243 national, regional, and international Iranian medical science congresses in the study time period. We selected and hand searched 67 out of 243 relevant congress` abstract books by two independent reviewers. We also searched the research projects of 29 out of 40 Iranian universities of medical sciences from their websites. We contacted the Center for Disease Control (CDC) of the Iranian Ministry of Health and the Iranian Blood Transfusion Organization (IBTO) for searching national reports from the study time period. Medical students' theses were also evaluated by two independent reviewers from the Iranian center for scientific documents and records (IranDoc). Finally, we consulted eight expert HCV researchers in Iran and searched their personal archives for additional citations. Forward and backward citations of searched items were also performed.

Critical appraisal and selection of studies

Two independent reviewers reviewed all citations thoroughly and checked for eligibility criteria to include the studies in the analysis. The inclusion criteria were all cross-sectional studies that specified temporal and geographic characteristics of the study; sufficiently declared objectives; and that used a valid sampling method that allowed for a generalization of the findings to the target population, valid measurement instruments for all study subjects, and appropriate analytic methods for the given sampling design and demographic characteristics. We revised the criteria developed by Sharifi et al. for this purpose (12).

Data extraction

After evaluating studies on these criteria, we extracted the findings of the included studies to Excel spreadsheets. The extracted data were year of the study, first author, province and district of the study, sample population, sampling method, sample size, HCV Antibody detection method, HCV Antibody kit name, mean age and standard error (SE) of subjects, percentage of male subjects, and HCV point prevalence in study subjects and/or in males/females and its SE. If there were other parameters reported other than SE, such as standard deviation, confidence interval, and/or P.value, the proper modifications were performed to calculate SE.

Statistical analysis

We analyzed the extracted data to estimate the point prevalence of HCV infection and its 95% confidence interval (CI) and used a Cochrane Q-test with a significance level of < 0.1 for checking the statistical heterogeneity of the results. We used a meta-analysis method with the "meta" command using fix/random model based on the results of the heterogeneity test. It seems that the meta-analysis method would not have been a suitable method to achieve the objectives of this systematic review because the weighting system of this method only considers sample size and not the size of the provincial population. We used a survey data analysis method to calculate the estimate of the nationwide prevalence rate considering the weight of each province as the ratio of the provincial population to the sample size(s), where the population of each province was retrieved  from the Iranian national census at 2006 (7).

In provinces with more than one prevalnce study (Tehran and Sistan-va-Baluchestan), the provincial prevalence was calculated by a meta-analysis of the studies, and the total sample size was determined by adding all study sample sizes. The analysis was performed with STATA 9.1 software (STATA Corp. LP). The results were shown in geographic maps using Arc View 3.2a software (ESRI Inc. NY).

Results

Search results

After review of studies, we found 190 related studies about HCV prevalence in Iran in literature review (13-192) from 264 studies that were found in electronic databases (Fig. 1). We found no additional unpublished findings on the HCV infection rate in the general population from Iranian medical congresses and reports.

Figure 1. Diagram of the systematic review and searches for HCV infection prevalence in I.R. Iran.

Studies

After excluding duplicate and overlapping reports to avoid double counting, we finally selected eleven studies with subjects in the general population. Out of these, two studies were on the Sistan-va-Baluchestan province (98, 113), and three studies were on the Tehran (49, 96, 185) province. From East Azarbaijan (81), Kermanshah (93), Chaharmahal-va-Bakhtiari (30), Khuzestan (35), Guilan (3), and Golestan  (25), one study from each province was included in our analysis.

HCV infection prevalence

The prevalence rate varied from 0% in the Khuzestan and Tehran provinces (35, 49) to 1.3% in the Guilan province (3). Reported percentages were heterogeneous and statistically significant (Test for heterogeneity: Q= 1607.73, df = 10, P < 0.001) (Fig. 2).

Figure 2. Forest plot of studies about HCV infection prevalence in I.R. Iran.

The overall estimate of the HCV prevalence rate in Iran according to data from eleven studies from eight provinces with an ELISA detection test (For HCV-antibody) was 4.45% (95%CI: 1.29%-7.61%). In three studies from Chaharmahal-va-Bakhtiari, East Azarbaijan, and Tehran (96), confirmatory tests were not used; therefore, the studies were excluded from the final analysis. Prevalence of HCV in Iran with Survey Data analysis according to the information from eight studies from six provinces with RIBA/PCR for HCV infection was %0.16 (95%CI: 0%-0.59%) (Fig. 3).

Figure 3. Prevalence of HCV in different provinces of Iran according to a RIBA/PCR test.

Discussion

The present study was designed to estimate the HCV infection prevalence rate in the Iranian general population according to available data from literature collected from different provinces by Iranian medical researchers. The prevalence of HCV in Iran with RIBA/PCR for HCV infection was 0.16%.

In our study, the prevalence of HCV infection was evaluated in only eight provinces. These provinces were among the most populous ones in Iran. The total population of these provinces was 30,468,756, making up 43.2% of the country's population. Despite the lack of data for the country as a whole, it seems that the overall estimate in these provinces represents a suitable estimate of the HCV prevalence for the whole country.

The highest HCV infection rate in Iranian general population was reported from one study on the residents of a Guilan nursing home (3). This rate might be due to the lower level of health in this sample. In two studies from Khuzestan (35) and Tehran (49), the HCV infection rate was reported to zero. These low rates could have been due to the study design or the type of sampling method and a small study population. HCV infection rates in provinces that border countries around Iran were significantly higher than the rates in the central regions of our country (Table 1). Some factors such as more contact with infected patients and a higher prevalence of HCV in our neighbors may explain the probable cause of the different prevalence of these provinces.

Table 1. HCV infection rate in several provinces of Iran.

Country region

Author/Year

Province

Neighbors

Kit

Sampl  e size

Prevalence

(%)

Reference

North

Ghanieie (2007)

Guilan

Azarbaijan (8.7%)

PCR

383

1.3

3

Ghadir M (2006)

Golestan

RIBA

2123

1

25

West

Sayad B (2008)

Kermanshah

Turkey (2.4%)

PCR

1721

0.87

93

Southeast

Salehi M (2001)

Sistan va Baluchestan

Pakistan (3%)

WB*

919

0.1

98

Moradi M (2007)

Sistan va Baluchestan

ELISA

365

0.8

113

 

Center

Vahdani P (2006)

Tehran

None

RIBA

102

0 £

49

Chamani L (2007)

Tehran

ND

1249

0.16

190

Southwest

Motlagh (2001)

Kuzestan

Kuwait (0.8)

RIBA

80

0 §

35

The HCV infection rate in Iranian general population is lower in comparison with other countries in our region (Eastern Mediterranean Region) and even many other countries like China, Europe, and the USA (193-202) (Table 2).

Table 2. HCV infection rate in several papers from the literature.

Author/Year

Country/region

Kit

Prevalence

Reference

Syed Asad Ali (2009)

Pakistan/EMRO

ND

3% (blood and non blood donors)

196

Sandesh K (2006)

India/EMRO

ND

0.33% (Blood donors)

197

Ameen. R (2005)

Kuwait/EMRO

ELISA

0.8% (Blood donors)

194

Daw. MA (2002)

Libya/EMRO

ELISA

1.6% (general population)

195

Erden S (2003)

Turkey/EMRO

-

2.4% (hospital based)

198

Lehman EM (2009)

Egypt/EMRO

-

13.9% (healthy populations)

199

Xia X (2008)

China/Asia

-

2.2% (general population)

200

Stvilia K (2006)

Georgia/Europe

RIBA

6.7% (general population)

201

Armstrong GL (2006)

USA/America

-

1.8% (Nationally representative household survey)

202

Galetski (1999)

Azarbaijan (Europe)

ND

8.7%

203

One of the causes of the notable difference in the HCV prevalence rate might be due to the handling of HCV prevention programs by some countries (203, 204). Preventive strategies in countries are based on health policy. Iranian prevention strategy for controlling the hepatitis C infection rate by harm reduction started 10 years ago. This strategy was accepted by the high-level officials of the government. More attention to high-risk groups to detect infected patients and screen and treat them was the fundamental basis of any program that was created with this strategy (205).

HCV prevention programs must be designed to control the risk factors that contribute to the transmission of HCV infection. Blood transfusion is one of the transmission routes of HCV infection. In developed countries, the residual risk for HCV infection through blood transfusion is lower and the current risk estimates per million donations are approximately 0.52 in the USA  (206), 0.7 in Canada (207), and 0.1-2.33 in different European countries (208-210), In some developed countries, due to defects in the collection of samples from non-remunerated blood donors, lack of trained professionals, and a poor supply of instruments and laboratory equipment for suitable blood transfusion, HCV transmission occurs more than in developing countries (211). In some studies, blood donors were selected as the general population. These samples are not actually representative of the general population and may have caused an underestimate of HCV infection in these studies (195). The prevalence rate of HCV in donor populations in some developing countries ranges between 1% and 7% (212-215). A high prevalence of 17% was reported in Egypt (216).

In Iran, we started a blood donor screening program in all Iranian blood transfusion centers in 1996. Some studies have shown that the HCV infection rate was significantly lower than before blood screening (29). The screening process and the elimination of high-risk donors are among the main causes of improvement in blood transfusion services in Iran (154, 192). The strict program of HCV infection screening prior to transfusion is one possible explanation for lower the prevalence of HCV infection rate in our country in comparison with other developing countries (217). Some studies have reported that HCV infection has specific epidemiological characteristics in hemodialysis patients (218-221), thalassemia patients (217), hemophilic patients (88, 222), and intravenous drug abusers (IDUS) (82). These patients are considered at-risk populations and are the primary source of HCV infection and can transmit HCV infection to other people as well. Some Iranian health programs have focused on screening transfused blood that is used for thalassemia and hemophilic patients and carefully controlling IDUS to help maintain and even decrease the HCV infection rate in the lower range (205, 223).

Fortunately, until now, Iranian prevention programs have focused on these special groups. We will control the HCV infection rate in the Iranian general population if we prevent the expansion of HCV infection from high-risk groups to the larger community. We will discuss this issue in our next systematic review, which will focus on special groups such as hemophiliacs, IDUSs, thalassemics, and patients who undergo hemodialysis.

Acknowledgments

This work was performed with the general support and a research grant from Baqiyatallah Research Center for Gastroenterology and Liver Disease, Baqiyatallah University of Medical Sciences and Health Services, Tehran, Iran, and support from the Nikan Health Researchers Institute, NHRI, Tehran, Iran.

The authors wish to thank Dr. Ali-Akbar Haghdoost from Kerman University of Medical Sciences, Iran, for his valuable and professional consultation and help with the study design and analysis of the results. We would like to thank Dr. Ahmad Reza Shamshiri from Tehran University of Medical Sciences, Iran, and Dr. Maziar Moradi-Lakeh from Iran University of Medical Sciences, Iran, for their valuable comments and contributions to monitoring the review and analysis processes. We would like to thank Mr. Vahid Mousavi Davar, Dr. Behzad Lotfi, and Dr. Mohhamad Naeem Bangash from Nikan Health Researches Institute (NHRI), Tehran, Iran, for their work on and help with the search processes. We would like to thank Dr. Navid Mohammadi from Qazvin University of Medical Sciences, and Dr. Morteza Naserbakht, Dr. Farnoush Davoudi, and Dr. Amir Davoudi from NHRI for their valuable help and consultation. Finally, we would like to thank Mrs. Aezam Rostamzad Sereshkeh and Miss. Fatemeh Mohammadifrom NHRI for their follow-up in the gray literature search.

References: (223)

  1. Simmonds P, Holmes EC, Cha TA, et al. Classification of hepatitis C virus into six major genotypes and a series of subtypes by phylogenetic analysis of the NS-5 region. J Gen Virol. 1993;74 ( Pt 11):2391-9. [PubMed]
  2. Rezvan H, Ahmadi J, Farhadi M. A preliminary study on the prevalence of anti-HCV amongst healthy blood donors in Iran. . Vox Sang. 1994;67(Suppl.2):A 100.
  3. Mansour-Ghanaei F, Fallah M, Jafarshad R, Joukar F, Pourtahmasbi A, Bahari-Moghaddam A. Seroprevalence of Hepatitis B and C among Residents of Guilan Nursing Home. Hepat Mon. 2007;7(3):139-1141. [HepatMon]
  4. Javadzadeh-Shahshahani H. [Comparison of the positive predicative value of two enzyme immunoassay screening kits for hepatitis C in blood donors]. Blood, Sci J Iranian Blood Transfus Org Res Cent. 2007;4(1):51-7. [Blood Journal]
  5. Samimi-Rad K, Shahbaz B. Hepatitis C virus genotypes among patients with thalassemia and inherited bleeding disorders in Markazi province, Iran. Haemophilia. 2007;13(2):156-63. [Haemophilia]
  6. Metanat M, Sharifi-Mood B, Sane'i-Moghaddam E, Alavi-Na'ini R, Naderi M, Khosravi S. [Prevalence of hepatitis C among diabetes mellitus patients in Zahedan]. Tabibe Shargh Res J. 2006;8(3):179-86. [TABIB-E-SHARGH]
  7. Kedda MA, Kew MC, Coppin A. Hepatocarcinogenic potential of genotype 5 of hepatitis C virus. Trop Gastroenterol. 1997;18(4):153-5. [NCBI]
  8. Brown RS, Jr., Gaglio PJ. Scope of worldwide hepatitis C problem. Liver Transpl. 2003;9(11):S10-3. [Wiley InterScience]
  9. Tillmann HL, Manns MP. Mode of hepatitis C virus infection, epidemiology, and chronicity rate in the general population and risk groups. Dig Dis Sci. 1996;41(12 Suppl):27S-40S. [PubMed]
  10. Van der Poel CL, Cuypers HT, Reesink HW, et al. Confirmation of hepatitis C virus infection by new four-antigen recombinant immunoblot assay. Lancet. 1991;337(8737):317-9. [PubMed]
  11. Gao Q, Liu D, Zhang S, Tong L. [Analyses of anti-hCV detected by ELISA and HCV RNA detected by RT-nPCR in chronic hepatitis C virus infectors]. Wei Sheng Yan Jiu. 2007;36(1):69-71. [NCBI]
  12. Sharifi V, Yousefi-Nooraie R, Rahimi-Movaqar A, Mesgarpour B, Basirnia A. Development of a quality assessment tool for prevalence studies in mental health [unpublished work].
  13. Tajbakhsh E, Ya'ghoobi R, Vahedi AR. [A serological survey on hepatitis C virus antibody in blood donors with an ELISA method]. Tehran Univ Med J. 2007;65(8):69-73. [TUMS]
  14. Bozorghi SH, Ramezany H, Vahid T, et al. [Assessment of prevalence and risk factors of hepatitis C virus infection in haemodialysis patients in Ghazvin]. Blood, Sci J Iranian Blood Transfus Org Res Cent. 2006;2(7):331-7. [Blood Journal]
  15. Zandieh T, Cohan N, Samiei S, Amini S, Ataei Z, Kavari M. Characteristics and prevalence of occult hepatitis B virus infection in patients with hepatitis C in Iran. Med J Islamic Republic of Iran. 2005;19(2):147-51. [Bioline]
  16. Ahmadi Pour MH, Keivani H, Sabahi F, Alavian SM. Determination of HCV genotypes, in Iran by PCR-RFLP. Iranian J Publ Health. 2006;35(4):54-61. [Scopus]
  17. Sarveghad MR, Bojdi A, Farrokhnia M, Javanian M. [Epidemiologic study of virus genotypes in chronic hepatitis C]. J Mashhad Sch Med. 2006;49(93):309-14. [MJMS]
  18. Shavakhi A, Esteghamat F, Sharifian A, et al. [Evaluation of hepatitis E in cirrhotic patients, a case control study]. Govaresh 2007;12(1):27-9. [Magiran]
  19. Ziaei M, Zarban A, Malekinejad P, Akhbari H. Evaluation of HGV viremia prevalence and its co-infection with HBV, HCV, HIV and HTLV-1 in hemophilic patients of Southern Khorassan, Iran. Hepat Mon. 2007;7(1):11-4. [HepatMon]
  20. Sadeghipoor HR, Agah S, Pajang R, et al. [Frequency determination of pathological findings regarding Ishak system in patients with chronic hepatitis and cirrhosis admitted to Rasoul-e-Akram hospital between 1997 to 2002]. J Iran Univ Med Sci. 2006;13(50):93-8. [SID]
  21. Zahedi MJ, Darvish-Moghadam S. [Frequency of Hepatitis B and C infections among Hemophiliac patients in Kerman]. J Kerman Univ Med Sci. 2004;3(11):131-5. [SID]
  22. Delavari M, Tabataba'i SM. [Frequency of hepatitis C and its related factors in blood donors in Kerman in 2003]. Journal of Army Univ Med Sci Islamic Republic of Iran. 2004;2(2):353-7. [IranMedex]
  23. Alavi S, Arzanian MT, Hatami K, Shirani A. [Frequency of hepatitis C in thalassemic patients and its association with liver enzymes, mofid hospital, Tehran, 2002]. Research in Medicine, J Shahid Beheshti Sch Med. 2005;29(3):213-7. [Pejouhesh]
  24. Esma'ili MR, Mostafazadeh A, Sharbatdaran M, Hajiahmadi M, Alijanpoor M. Hepatitis C in blood products receivers. Iran J Pediatr. 2004;14(1):15-20. [TUMS]
  25. Ghadir MR, Jafari E, Amiriani MT, Rezvan H, Amini S, Pourshams A. [Hepatitis C in Golestan Province, Iran]. Govaresh. 2006;11(3):158-62. [Magiran]
  26. Jabbari A, Besharat S, Khodabakhshi B. Hepatitis C in hemodialysis centers of Golestan province, northeast of Iran (2005). Hepat Mon. 2008;8(1):61-5. [HepatMon]
  27. Alavian SM, Hajariazdeh B, Malekzadeh R. [Hepatitis C in Hemophiliacs]. Govaresh. 2003;8(4):139-48. [IAGH]
  28. Alavian SM, Gholami B, Masarrat S. Hepatitis C risk factors in Iranian volunteer blood donors: A case-control study. J Gastroenterol Hepatol. 2002;17(10):1092-7. [Scopus]
  29. Akbari A, Imanieh MH, Karimi M, Tabataba'i HR. Hepatitis C virus antibody positive cases in multitransfused thalassemic patients in South of Iran. Hepat Mon. 2007;7(2):63-6. [HepatMon]
  30. Hosseini Asl SK. High prevalence of HIV, HBV, HCV infection in gypsy population residing in Chaharmahal and Bakhtiari province. J Thromb Haemost. 2003;1:1. [Acta Physiologica]
  31. Amini Kafi-Abad S, Talebian A, Ranjbar-Kermani F, Moghtada'i M, Sobhani M, Sami'i S. [Mini-pool screening for HCV infection in Iranian blood donors: Preliminary results]. Blood, Sci J Iranian Blood Transfus Org Res Cent. 2005;2(3):13-21. [Blood Journal]
  32. Alavian SM. Networking for Overcoming on Viral Hepatitis in Middle East and Central Asia:"Asian Hepatitis Network". Hepat Mon. 2007;7(4):181-2. [HepatMon]
  33. Saboor B, Boroomand P, Mehrabi Y, Ghanbari M, Zarrinfam H. [Prevalence and risk factors of hepatitis C infection in hemodialysis patients (Kermanshah ,1999 - 2000)]. Behbood, J Kermanshah Univ Med Sci. 2003;7(3):60-6.
  34. Khani M, Vakili MM. Prevalence and risk factors of HIV, hepatitis B virus and hepatitis C virus infections in drug addicts among Zanjan prisoners. Arch Iran Med. 2003;6(1):1-4. [Scopus]
  35. Motlagh ME, Makvandi M, Jalali MT. [Prevalence of anti-HCV among pregnant women]. J Qazvin Univ Med Sci. 2001(18):59-63. [JQUMS]
  36. Rowhani-Rahbar A, Tabatabee-Yazdi A, Panahi M. Prevalence of common blood-borne infections among imprisoned injection drug users in Mashhad, North-East of Iran. Arch Iran Med. 2004;7(3):190-4. [Scopus]
  37. Poorahmad M, Javady AA, Karimi I, Ata'i B, Kassa'ian N. Seroprevalence of and risk factors associated with hepatitis B, hepatitis C, and human immunodeficiency virus among prisoners in Iran. Infect Dis Clin Pract. 2007;15(6):368-72. [WANFANG DATA]
  38. Mohtasham-Amiri Z, Rezvani M, Ja'fari-Shakib R, Ja'fari-Shakib A. [Prevalence of HCV and high-risk behaviors in drug addiction inmates in Rasht, Iran]. Payesh. 2007;6(1):5-10. [Payesh Journal]
  39. Alavian SM, Kafaee J, Yektaparast B, et al. [Prevalence and risk factors for aquiring hepatitis C in hemodialysis patients in Gazvin (2001)]. J Qazvin Univ Med Sci. 2004;29:16-20.
  40. Ziaei M, Namaei MH, Hosseini SM, Azarkar SG. [Prevalence of HCV infection and related viremia in hemophilic patients registered in Khorasan hemophilia society]. Ofogh-e-Danesh, J Gonabad Univ Med Sci. 2005;11(3):54-60. [OFOGH-E-DANESH]
  41. Alavian S, M., Ardeshiri A, Hajarizadeh B. [Prevalence of HCV, HBV and HIV infections among Hemophiliacs]. Hakim Res J. 2003;2(6):45-51. [SID]
  42. Sane'i-Moghaddam E, Savadkoohi S, Rakhshani F. [Prevalence of hepatitis B and C in patients with major Beta-thalassaemia referred to Ali-Asghar hospital In Zahedan, 2002]. Blood, Sci J Iranian Blood Transfus Org Res Cent. 2004;1(1):19-26. [Blood Journal]
  43. Torabi SE, Abed-Ashtiani K, Dehkhoda R, et al. [Prevalence of Hepatitis B and C in Thalassemic patients of East Azarbaijan in 2003]. Blood, Sci J Iranian Blood Transfus Org Res Cent. 2005;2(4):115-23. [Blood Journal]
  44. Mansour-Ghanaei F, Fallah MS, Ja'farshad R, et al. [Prevalence of hepatitis B and hepatitis C, and their risk factors among Guilan blood donors]. Blood Sci J Iranian Blood Transfus Org Res Cent. 2008;4(Sup 5):331-6. [Blood Journal]
  45. Mahdaviani F, Saremi S, Rafiee M. [Prevalence of hepatitis B, C and HIV infection in thalassemic and hemophilic patients of Markazi province in 2004]. Blood, Sci J Iranian Blood Transfus Org Res Cent. 2008;4(5):313-22. [Blood Journal]
  46. Mansour-Ghanaei F, Fallah MS, Ja'farshad R, Joukar F, Salari A, Tavafzadeh R. Prevalence of hepatitis B surface antigen and hepatitis C virus antibody and their risk factors among Guilan's volunteer blood donors (1998-2003). Hepat Mon. 2007;7(4):239-41. [HepatMon]
  47. Torabi SE, Abed-Ashtiani K, Dehkhoda R, et al. [Prevalence of hepatitis B, C and HIV in hemophiliac patients of East Azarbaijan in 2004]. Blood, Sci J Iranian Blood Transfus Org Res Cent. 2006;2(Sup 7):291-9. [Blood Journal]
  48. Hasanpour SE, Arasteh E, Ghorbani S, Mahdavi S. [Prevalence of Hepatitis B, Hepatitis C and HIV infection in 15 year and older patients admitted in hand surgery emergency]. J Kordestan Univ Med Sci. 2003;8(1):25-33. [IranMedex]
  49. Vahdani P, Hosseini-Moghaddam SMM, Gachkar L, Sharafi K. Prevalence of hepatitis B, hepatitis C, human immunodeficiency virus, and syphilis among street children residing in southern Tehran, Iran. Arch Iran Med. 2006;9(2):153-55. [AIM]
  50. Faranoush M, Ghorbani R, Amin-Bidokhti ME, Vosoogh P, Malek M, Yazdiha MS. [Prevalence of Hepatitis C resulted from blood transfusion in major Thalassemia patients in Semnan, Damghan and Garmsar, 2002]. J Hormozgan Univ Med Sci. 2006;1(10):82-77. [HMJ]
  51. Hajia M, Shahrokhi N, Amirzargar AA, et al. Prevalence of hepatitis C virus among out-patients of a private laboratory in Tehran. Iranian J Publ Health. 2007;36(1):79-84. [TUMS]
  52. Samimi-Rad K, Shahbaz B, Noroozi M, Mahmoodi M, Fayyaz-Vaseghi M. [Prevalence of hepatitis C virus antibody and related risk factors among hemodialysis patients in Markazi province (2004)]. Rahavard-E Danesh , J Arak Univ Med Sci. 2006;9(1):23-33. [SID]
  53. Moula K, Hajiani E. Prevalence of hepatitis C virus infection in patients with systemic lupus erythematosus: A case-control study. Hepat Mon. 2008;8(1):41-4. [HepatMon]
  54. Rezazadeh M, Mani-Kashani K, Mohammadi A, et al. Prevalence of human immunodeficiency, hepatitis B and hepatitis C viruses in the first time, repeat and regular donors in blood transfusion center, Hamadan, 2004-2005. Iran J Infect Dis Trop Med. 2006;11(33):55-60.
  55. Kasraian L, Torabjahromi SA. [Prevalence of major transfusion transmitted viral infections (HCV, HBV, HIV) in Shiraz blood donors from 2000 to 2005]. Blood, Sci J Iranian Blood Transfus Org Res Cent. 2007;5(3):373-8. [Blood Journal]
  56. Kamangar E, Atapour M, Sanei-Moghadam E, Zohour AR, Nayeb-Aghaei SM. [Prevalence of serologic markers of Hepatitis B and C and risk factors among dentists and physicians in Kerman, Iran]. J Kerman Univ Med Sci. 2003;4(10):245-0. [IranMedex]
  57. Einollahi B, Hajarizadeh B, Bakhtiari S, et al. Pretransplant hepatitis C virus infection and its effect on the post-transplant course of living renal allograft recipients. J Gastroenterol Hepatol. 2003;18(7):836-40. [Scopus]
  58. Bozorghi SH, Ramezani H, Vahid T, et al. [The prevalence and risk factors of hepatitis C virus infection among thalassemic patients of Qazvin (2005)]. J Qazvin Univ Med Sci. 2008;11(4):54-9. [JQUMS]
  59. Mohammad-Alizadeh AH, Ranjbar M, Seyfoleslami SAR. The frequency of hepatitis C in dialyse patients in Hamadan Ekbatan hospital. Iran J Infect Dis Trop Med. 2002;7(19):27-34. [IranMedex]
  60. Alavian SM, Hatami S. [Etiology and Risk factors of Acute Viral Hepatitis in Adult Patients reffered to Tehran Hepatitis Center from 2000-2001]. Govaresh. 2001;125(6):125-30.
  61. Salehi AA, Sharifi M, Norooz-Nejad M, Vazirian Sh. [Seroepidemiology of HIV, HBV & HCV infections in laboratory staff, Kermanshah, 2002]. Behbood, J Kermanshah Univ Med Sci. 2004;19(7):54-49. [SID]
  62. Moniri R, Mosayyebi Z, Moosavi GA. Seroprevalence of cytomegalovirus, hepatitis B, hepatitis C and human immunodeficiency virus antibodies among volunteer blood donors. Iranian J Publ Health. 2004;33(4):38-42. [SID]
  63. Nassiri-Toosi M, Larti F, Rasteh M, et al. Risk factors and seroprevalence of hepatitis B and C infections among hemodialysis patients in Tehran. Iran J Patho. 2007;2(4):181-6. [IJP]
  64. Tamaddoni A, Mohammadzadeh I, Zia'i O. Seroprevalence of HCV antibody among patients with beta-thalassemia major in Amirkola Thalassemia Center, Iran. Iran J Allergy Asthma Immunol. 2007;6(1):41. [NCBI]
  65. Saffar MJ, Jooyan AR, Mahdavi MR, Khalilian AR. Seroprevalence of hepatitis A, B, and C and hepatitis B vaccination status among health care workers in Sari-Iran, 2003. J Mazandaran Uni Med Sci. 2005;15(47):67-77. [MAZUMS]
  66. Ghafoorian-Broujerdnia M, Assarehzadegan MA, Zandian Kh. Seroprevalence of Hepatitis B, Hepatitis C and human immunodeficiency virus (HIV) among Thalassemia patients refer to Ahwaz Shapha Hospital, 1999-2004. Scientific Medical Journal. 2006;5(2):528-37. [IranMedex]
  67. Karimi M, Ghavanini AA. Seroprevalence of hepatitis B, hepatitis C and human immunodeficiency virus antibodies among multitransfused thalassaemic children in Shiraz, Iran. Journal of Paediatrics and Child Health. 2001;37(6):564-6. [Scopus]
  68. Mohtasham-Amiri Z, Ja'fari-Shakib A, Toorchi-Roodsari M. Seroprevalence of hepatitis C and risk factors in hemodialysis patients in Guilan province, Iran. Payesh. 2003;2(4):291-5. [Payesh Journal]
  69. Behnaz MA, Behnaz F, Mohammadzadeh M. [The prevalence of hepatitis C infection among the dentists of Yazd and assessment of their knowledge about hepatitis]. J Dent. 2004;17(1):55-9. [TUMS]
  70. Hadadi A, Afhami S, Karbakhsh M, et al. [Epidemiological determinants of occupational exposure to HIV, HBV and HCV in health care workers]. Tehran Univ Med J. 2007;65(9):59-66. [TUMS]
  71. Hariri MM, Akbari N, Yavari FM, Javadi E, Javer SH. [Prevalence of Hepatitis B, C and HIV markers in Thalassemic and Hemophilic patients in Isfahan, 2004]. Blood, Sci J Iranian Blood Transfus Org Res Cent. 2006;2(3):201-4. [Blood Journal]
  72. Javadi AA, Poorahmad M, Ata'i B. [The relationship between frequency and duration of imprisonment and the prevalence of HBsAg, AntiHCV and HIV antibody seropositivity in Iranian prisoners]. J Iran Med Council. 2006;24(4):358-64.
  73. Pourshams A, Malekzadeh R, Akbari MR, Mer'at S. Prevalence and causes of elevated ALT levels among Iranian healthy blood donors. Gastroenterology. 2004;126(4):A307. [NBCI]
  74. Javadzadeh-Shahshahani H, Attar M, Yavari M, T., Savabieh Sh. [Study of the prevalence of Hepatitis B, C and HIV infection in Hemophilia and Thalassemia population of Yazd in 2003]. Blood, Sci J Iranian Blood Transfus Org Res Cent. 2006;2(7):315-22. [SID]
  75. Shamsian B, Arzanian MT, Shamshiri AR, Alavi S, Khojasteh O. [Blood transfusion status in beta major thalassemia patients in Mofid Children Hospital in Tehran]. Blood, Sci J Iranian Blood Transfus Org Res Cent. 2008;4(4):253-8. [Blood Journal]
  76. Zali MR, Aghazadeh R, Nouroozi A, Amirrasooli H. Anti-HCV antibody among Iranian IV drug users: Is it a serious problem? Arch Iran Med. 2001;4(3):115-9. [AMS]
  77. Zahedi MJ, Zand V, Tavakoli M, Hajariazdeh B, Alavian SM. [The prevalence of hepatitis B and C among thalassemia major patients in Kerman, Iran, and the role of transfusion in infection acqusition]. Govaresh. 2003;8(44):72-8. [SID]
  78. Taziki O, Espahbodi F. Prevalence of hepatitis C virus infection in hemodialysis patients. Saudi J Kidney Dis Transpl. 2008;19(3):475-8. [SIKDT]
  79. Taremi M, Khoshbaten M, Gachkar L, EhsaniArdakani M, Zali M. Hepatitis E virus infection in hemodialysis patients: a seroepidemiological survey in Iran. BMC Infect Dis. 2005;5(1):36. [NCBI]
  80. Taremi M, Gachkar L, MahmoudArabi S, Kheradpezhouh M, Khoshbaten M. Prevalence of antibodies to hepatitis E virus among male blood donors in Tabriz, Islamic Republic of Iran. East Mediterr Health J. 2007;13:98-102. [NCBI]
  81. Tanomand A, Montazam H, Kafshnochi M. Seroepidemiology of hepatitis C antibody between rural and urban people: A retrospective study in June to December of 2005 in Malekan City, Iran. Res J Biol Sci. 2007;2(5):561-3. [MJ]
  82. Talaie H, Shadnia SH, Okazi A, Pajouhmand A, Hasanian H, Arianpoor H. The prevalence of hepatitis B, hepatitis C and HIV infections in non-IV drug opioid poisoned patients in Tehran-Iran. Pakistan J Biol Sci. 2007;10(2):220-4. [Scopus]
  83. Somi M, H., Keivani H, Ardalan MR, Farhang S, Pouri AA. Hepatitis C virus Genotypes in patients with End-Stage Renal Disease in East-Azarbaijan, Iran. Saudi J Kidney Dis Transpl. 2008;19(3):461-5. [KFUPM ePRINTS]
  84. Sharifi-Mood B, Sanei-Moghaddam S, Salehi M, Eshghi P, Khosravi S, Khalili M. Viral infection among patients with hemophilia in the Southeast of Iran. J Med Sci. 2006;6(2):225-8. [Scopus]
  85. Sharifi-Mood B, Metanat M. Co-infection HIV/AIDs and Hepatitis C. Intern J Virol. 2006;2:63-6. [SCINSE ALERT]
  86. Sharifi-Mood B, Metanat M. Infection among hospitalized injection drug users. J Med Sci. 2006;6(4):686-9. [Scopuse]
  87. Sharifi-Mood B, Khosravi S. Tattooing: A major source for viral infection. J Med Sci. 2006;6(4):678-80. [Scopus]
  88. Sharifi-Mood B, Eshghi P, Sanei-Moghaddam E, Hashemi M. Hepatitis B and C virus infections in patients with hemophilia in Zahedan, southeast Iran. Saudi Medical Journal. 2007;28(10):1516-9. [Scopus]
  89. Shariatzadeh SMA, Nadderi GhA. [Study of HBV, HIV and HCV infection in major Thalassemic patients in Central province of Iran]. J Uromia Univ Med Sci. 2000;1(11):28-0
  90. Abdollah-Shamshirsaz A, Kamgar M, Bekheirnia M, et al. The role of hemodialysis machines dedication in reducing Hepatitis C transmission in the dialysis setting in Iran: A multicenter prospective interventional study. BMC nephrology. 2004;5(13). [PubMed]
  91. Seyrafian S, Mobasherizadeh S, Javadi A, Akhzari M, Esfandiari J. Comparison and prevalence of hepatitis B and C infection and hepatitis B vaccination in hemodialysis patients and staffs in 13 hemodialysis centers in Isfahan (Iran). Nephrol Dial Transpl. 2006;21((Suppl 4)):iv 484.
  92. Semnani S, Roshandel GR, Abdolahi N, et al. HBV/HCV co-infection in Iran: A seroepidemiological based study. Pakistan J Biol Sci. 2006;9(13):2538-40. [KFUPM]
  93. Sayad B, Shamseddin-Saeed F, Keyvani H, et al. Seroepidemiology of hepatitis C in Kermanshah (West of Iran, 2006). Hepat Mon. 2008;8(2):141-6.
  94. Sane'i-Moghaddam E, Khosravi S, Gharibi T. Prevalence of HBsAg and Anti-HCV reactivity in donors embarking on direct blood donation and among first-time blood donors in Zahedan Blood Transfusion Center [In Persian]. Blood, Sci J Iranian Blood Transfus Org Res Cent. 2005;1(2):19-25. [SID]
  95. Sana'izadeh H, Taghaddosinejad F, Amo'i M, Bayatmakoo K, Fahim P. Autopsies on bodies without antemortem risk factors for HCV, HBV and HIV infections: Are they safe? Pathology. 2002;34(6):582-3. [NCBI]
  96. Sana'izadeh H. Seroprevalence of HIV, HBV and HCV in forensic autopsies, which have been presumed to be low risk, in Tehran, the Capital of Iran. Internet J Pathol. 2002;2(1). [ISPUB]
  97. Salehi M, Sharifi B. Acute viral hepatitis in Zahedan: A serological analyzes of 263 case. J Med Sci. 2005;5(2):101-5. [JMedSci]
  98. Salehi M, Sane'i-Moghaddam E, Bozorgzadeh SR, Haghighi MR. [Seroepidemiology of hepatitis C in Sistan and Baloochestan province.] Tabibe Shargh Res J. 2001;3(3):165-8. [TABIB-E-SHARGH]
  99. Salehi M, Sanei-Moghaddam E, Ansari-Moghaddam AR. [HBsAg and Hepatitis C infection prevalence in prisoners of Sistan and Baloochestan province]. Tabibe Shargh Res J. 2001;3(4):203-6. [TABIB-E-SHARGH]
  100. Salehi M, Sanei ME, Khosravi S. [Etiology of acute viral Hepatitis in Zahedan]. Research in Medicine, J Shahid Beheshti Sch Med. 2003;4(26):245-8. [KFUPM]
  101. Sadegi-Bazargani H, Arshi S, Mortazazadeh AA, et al. [Health status among migrant tribes (Ashayer) of Ardabil province]. J Ardabil Univ Med Sci. 2005;5(2):150-5. [IranMedex]
  102. Sadeghi A. [Prevalence of Hepatitis B and C in blood donors in East Azarbaijan province]. J Uromia Univ Med Sci. 1998;9(4):242.
  103. Sabayan B, Mo'tamedifar M, Zamiri N, Karamifar K, Chohedry A. Viral infections, prevalence and costs: A 5-year, hospital based, retrospective observational study in Shiraz, Iran. Pak J Med Sci. 2007;23(4):580-4. [Medical Sciences]
  104. Rezvan H, Moosavi-Jahed Z. Prevalence etiology of acute viral hepatitis in hospitalized patient at infectious ward of 5 major teaching hospitals, Tehran. Iran J Infect Dis Trop Med. 2003;8(21):40-3. [IranMedex]
  105. Rahbar AR, Rooholamini S, Khoshnood K. Prevalence of HIV infection and other blood-borne infections in incarcerated and non-incarcerated injection drug users (IDUs) in Mashhad, Iran. Int J Drug Pol. 2004;15(2):151-5. [Scopus]
  106. Pourshams A, Malekzadeh R, Monavvari A, et al. Prevalence and etiology of persistently elevated alanine aminotransferase levels in healthy Iranian blood donors. J Gastroenterol Hepatol. 2005;20(2):229-33. [PubMed]
  107. Poormand GR, Poormand MR, Salem S, et al. [Post-transplantation infectious complications in Iranian kidney recipients: A prospective study of 142 patients]. J Sch Public Health & Health Res Inst. 2006;4(2):59-71. [TUMS]
  108. Pourazar A, Abkbari N, Hariri M, Yavari F, Akbari Sh. [Evaluation of demographic profiles and prevalence of major viral markers in first time vs repeat blood donors in Isfahan]. Blood, Sci J Iranian Blood Transfus Org Res Cent. 2006;2(7):323-9. [Blood Journal]
  109. Mahmoodian-Shooshtari M, Poorfathollah AA. An overview analysis of blood donation in the Islamic Republic of Iran. Arch Iran Med. 2006;9(3):200-3. [NBCI]
  110. Nour-Kojory S, Alaoddowleie H, Seddighian F. [Efficacy of confidential self-exclusion and failed systems on blood donation safety in Sari and Behshahr blood donors]. Blood, Sci J Iranian Blood Transfus Org Res Cent. 2007;4(2):153-8. [Blood Journal]
  111. Nobakht-Haghighi A, Zali M, R,, Nouroozi A. Hepatitis C antibody and related risk factors in hemodialysis patients in Iran. J Am Soc Nephrology. 2001;12:233A
  112. Mojtabavi-Na'ini M, Derakhshan F, Hoorfar H, Derakhshan F, Makarian-Rajab F. Analysis of the related factors in hepatitis C virus infection among hemophilic patients in Isfahan, Iran. Hepat Mon. 2007;7(2):59-62. [HepatMon]
  113. Moradi A, Mohagheghi AH, Shahraki S, et al. Seroepidemiology of rubella, measles, HBV, HCV and B19 virus within women in child bearing ages (Saravan City of Sistan and Bloochastan Province). Res J Microbiol. 2007;2(3):289-93. [Scopus]
  114. Mirnaseri SMM, Poostchi H, Nasseri-Moghaddam S, et al. [HCV in intravenous drug users]. Govaresh. 2005;10(2):80-6. [MagIran]
  115. Mirmomen S, Alavian SM, Hajarizadeh B, et al. Epidemiology of hepatitis B, hepatitis C, and human immunodeficiency virus infecions in patients with beta-thalassemia in Iran: a multicenter study. Arch Iran Med. 2006;9:319-23. [NCBI]
  116. Mirahmadizadeh AR, Kadivar MR, Hemmati AR, Javadi A. Infection with HIV and hepatitis C and B viruses among injecting drug users in Shiraz, Southern Iran. 15th Int Conf AIDS; 2004 2004 Jul 11-16; Bangkok, Thailand.; 2004.
  117. Masaeli Z, Jaberi M, R,, Magsoudlou M. [A comparison of seroprevalence of blood-borne infections among regular, sporadic and first-time blood donors in Isfahan]. Blood, Sci J Iranian Blood Transfus Org Res Cent. 2006;2(7):301-7. [Blood Journal]
  118. Mardani A, Hosseini S, Kheirkhahi N. [Study of confidential self-exclusion cases in Qom Regional Blood Transfusion Center]. Blood, Sci J Iranian Blood Transfus Org Res Cent. 2006;3(2):183-9. [Blood Journal]
  119. Mansour-Ghanaei F, Forootan H, Fallah MS, et al. [Hepatitis viruses seromarkers and liver function in Guilan hemophilia]. J Guilan Univ Med Sci. 2002;10(39-40):56-64. [IranMedex]
  120. Makhloogh A, Mahdavi MR, Haghshenas M, Ghasemian R, Jamshidi M. Hepatitis C prevalence in hemodialysis patients in Mazandaran, Iran: A survey by polymerase chain reaction and serological methods. Res J Biol Sci. 2008;3(2):265-8. [NCBI]
  121. Mahdaviani F, Saremi S, Maghsoodloo M, Poorfathollah AA. [Prevalence of blood transmitted viral infections in regular and non-regular donors of Arak Blood Center]. Blood, Sci J Iranian Blood Transfus Org Res Cent. 2006;2(Sup 7):343-51. [BloodJuornal]
  122. Khodadadizadeh A, Esmaeili-Nadimi A, Hosseini SH, Shabani-Shahrbabaki Z. [The Prevalence of HIV, HBV and HCV in Narcotic addicted Persons Referred to the out Patient Clinic of Rafsanjan University of Medical Sciences in 2003]. J Rafsanjan Univ Med Sci. 2006;1(5):23-30. [IranMedex]
  123. Kheradpezhouh M, Taremi M, Gachkar L, Aghabozorgi S, Khoshbaten M. Presence and significance of transfusion-transmitted virus infection in Iranian patients on maintenance hemodialysis. J Microbiol Immunol Infect. 2007;40(2):106-11. [NCBI]
  124. Khedmat H, Fallahian F, Abolghasemi H, et al. Seroepidemiologic Study of Hepatitis B Virus, Hepatitis C Virus, Human Immunodeficiency Virus and Syphilis Infections in Iranian Blood Donors. Pak J BioI Sci. 2007;10(24):4461-6. [NBCI]
  125. Khadem-Ansari MH, Omrani M. Evaluation of diagnostic value of ELISA method (EIA) & PCR in diagnosis of hepatitis C virus in hemodialysis patients. Hepat Mon. 2006;6(1):19-23. [HepatMon]
  126. Kasraian L, Torab-Jahromi A, Farahangiz B. A survey of epidemiological status of hepatitis C infection among Shirazian blood donors in 2005. J Clin Virol. 2006;36:S214. [ISVHLD]
  127. Kasraian L, Torab-Jahromi A, Farahangiz B. Trends in incidence of major transfusion transmissible viral infection in Fars blood donors from 2002 till end of 2006. Vox Sanguinis. 2006;91:39-40. [Vox Sanguinis]
  128. Kashef S, Karimi M, Amirghofran Z, et al. Antiphospholipid antibodies and hepatitis C virus infection in Iranian thalassemia major patients. Int J Lab Hematol. 2008;30(1):11-6. [NBCI]
  129. Karimi A. Seroprevalence of HBV, HCV and HIV among intravenous drug users in Iran. J Clin Virol. 2006;36:S210-1. [PubMed]
  130. Kadivar MR, Mirahmadizadeh MR, Karimi A, Hemmati A. The prevalence of hepatitis C and Human Immunodeficiency Virus antibodies in thalassemic patients in Shiraz. Med J Iran Hosp. 2001;4(1):18-21.
  131. Javadi AA, Avijgan M, Hafizi M. Prevalence of HBV and HCV infections and associated risk factors in addict prisoners. Iranian J Publ Health. 2006;35(4):33-6.
  132. Jahangirnejad M, Makvandi M, Kelishadi M, Eizadikha V. Study on hepatitis C virus infection among the dental students. Biochem Cell Arch. 2006;6(1):65-9. [SID]
  133. Jadali Z, Eslami MB, San'ati MH, et al. Hepatitis C virus antibodies and Vitiligo disease. Iranian J Publ Health. 2005;34(1):23-6. [Iranian J Publ Health]
  134. Mohtasham-Amiri Z. Prevalence of hepatitis C virus infection and risk factors in an incarcerated population in Iran. J Thromb Haemost. 2003;1:1. [WHO]
  135. Imani R, Karimi A, Kasaeian N. [The relevance of related-risk behaviors and seroprevalence of HBV, HCV and HIV infection in intravenous drug users from Shahrekord, Iran, 2004]. J Shahrekord Univ Med Sci. 2006;1(8):58-62. [IranMedex]
  136. Hosseini-Moghaddam SM, Keyvani H, Kasiri H, et al. Distribution of hepatitis C virus genotypes among hemodialysis patients in Tehran--a multicenter study. J Med Virol. 2006;78(5):569-73. [NCBI]
  137. Hajiani E, Hashemi J, Masjedizadeh R, Shayesteh AA, Idani E, Rajabi T. Seroepidemiology of hepatitis C and its risk factors in Khuzestan Province, south-west of Iran: a case-control study. World J Gastroenterol. 2006;12(30):4884-7. [PubMed]
  138. Hajiani E, Masjedizadeh R, Hashemi J, Azmi M, Rajabi T. Hepatis C virus transmission and its risk factors within families of patients infected with hepatitis C virus in southern Iran: Khuzestan. . World J Gastroenterol. 2006;12(43):7025-8. [PubMed]
  139. Ghaderi AA, Makhmalbaf Z. The relationship between lichen planus and hepatitis C in Birjand, Iran. Shiraz E-Medical Journal. 2007;8(2):72-9. [SUMS]
  140. Ganji A, Safavi M, Noura'i M, et al. [Digestive and liver diseases statistics in several referral centers in Tehran, 2000-2004]. Govaresh. 2006;11(1):33-8. [Magiran]
  141. Farzaneh S, Reza SM, Reza SH. Molecular characteristic and epidemiology of hepatitis B, C viruses in the Shiraz Province of Iran. J Clin Virol. 2006;36:S36. [Science Direct]
  142. Esma'ili MR, Mostafazadeh A, Sharbatdaran M, Hajiahmadi M, Alijanpoor M. Hepatitis C in blood products receivers due to acute illness before screening program. Pediatr Res. 2005;58(2):373. [Pediatric Research]
  143. Esma'ili H, Hamidiya Z, Mirlatifi S, et al. Seroprevalence of blood-borne infections among blood donors in Boushehr, Iran. Int J Antimicrob Ag. 2007;29:S337. [ESCMID]
  144. Mansour-Ghanaei F, Fallah MS, Shafaghi A, et al. Prevalence of hepatitis B and C seromarkers and abnormal liver function tests among hemophiliacs in Guilan (northern province of Iran). Med Sci Monit 2002;8:797-800. [NCBI]
  145. Cohan N, Zandeh T, Samiei SH, Ataie Z, Kavari M. The prevalence and clinical significance of hepatitis B and C coinfection. Iran J Med Sci. 2006;31(3):156-8. [IJMS]
  146. Broumand B, Abdollah-Shamshirsaz AR, Kamgar M, et al. Prevalence of hepatitis C infection and its risk factors in hemodialysis patients in Tehran: Preliminary report from "the effect of dialysis unit isolation on the incidence of hepatitis C in dialysis patients" project. Saudi J Kidney Dis Transpl. 2002;13(4):467-72. [NCBI]
  147. Broumand B, Kamgar M, Bekheirnia M, et al. Incidence of hepatitis C virus infection and its risk factors among hemodialysis patients in Tehran: A multicenter study. J Am Soc Nephrol. 2003;14:852A.
  148. Bozorghi SH, Ahmadzad-Asl M, Ramezani H, Kargarfard H, Alavian SM. [Study of Viral Infections Prevalence in Blood Donors of Qazvin Province in Different Time Intervals and During Bam Earthquake]. Govaresh. 2007;4(11):242-8. [IAGH]
  149. Khodabakhshi B, Abbasi A, Fada'i F, Rabi'i MR. Prevalence and risk factors of HIV, hepatitis B virus and hepatitis C virus infections in drug addicts among Gorgan prisoners. J Med Sci. 2007;7(2):252-4. [KFUPM]
  150. Attarchi Z, Ghafouri M, Hajibeigi B, Assari Sh, [Alavian SM. Donor deferral and blood-borne infections in blood donors of Tehran]. Blood, Sci J Iranian Blood Transfus Org Res Cent. 2005;7(2):353-64. [Blood Journal]
  151. Assarehzadegan MA, Shakerinejad G, Amini A, Rezaee SA. Seroprevalence of hepatitis E virus in blood donors in Khuzestan Province, Southwest Iran. Int J Infect Dis. 2008;12(4):387-90. [NCBI]
  152. Asadi S, Marjani M. [Epidemiology and prevalence of infectious diseases in IVDA in Infectious Wards of Shahid Beheshti University of Medical Sciences, 1381-82]. Iran J Infect Dis Trop Med. 2004;25(9):53-61. [IranMedex]
  153. Ansari A, Tabatabai SH. [Study of factors in major beta thalassemia complications in patients admitted to Shahid Dastghaib hospital in Shiraz, Iran (2004-5)]. J Sabzevar Med Sci. 2007;14(1):62-72. [IranMedex]
  154. Ansari H, Kamani H, Arbabi-Sarjo A. Prevalence of hepatitis C and related factors among beta-thalassemia major patients in Southern Iran in 2005-2006. J Med Sci. 2007;7(6):997-1002. [ANSI]
  155. Ansar MM, Kooloobandi A. Prevalence of hepatitis C virus infection in thalassemia and haemodialysis patients in north Iran-Rasht. J Viral Hepatitis. 2002;9(5):390-2. [NCBI]
  156. Mohtasham Amiri Z, Rezvani M, Jafari Shakib R, Jafari Shakib A. Prevalence of hepatitis C virus infection and risk factors of drug using prisoners in Guilan province. East Mediterr Health J. 2007;13(2):250-6. [PubMed]
  157. Aminzadeh Z, Aghazadeh-Sarhangipoor K. Seroepidemiology of HIV, syphilis, hepatitis B and C in intravenous drug users at Loghman Hakim hospital. Iran J Med Microbiol. 2007;1(3):53-6. [IranMedex]
  158. Amini S, Mahmoodabadi SA, Lamian S, Joola'i M, Mahmoodi-Farahani M. Prevalence of hepatitis G virus (HGV) in high-risk groups and blood donors in Tehran, Iran. Iranian J Publ Health. 2005;34(4):41-6. [IJPH]
  159. Mohammad-Alizadeh AH, Alavian SM, Jafari K, Yazdi N. Prevalence of hepatitis C virus infection and its related risk factors in drug abuser prisoners in Hamedan--Iran. World J Gastroenterol. 2005;11(26):4085-9. [NCBI]
  160. Alavi-Na'ini R, Sharifi-Mood B, Metanat M, et al. Risk factors of hepatitis C infection among household contacts in Zahedan. J of Mil Med. 2006;7(4):343-8. [MilMed]
  161. Alavian SM, Rajai M, Arab MS, et al. Viral Hepatitis in Iranian Armed Forces: Prevalence of HBV and HCV in the Wounded-In-Action (WIA). Hepat Mon. 2005;4(5):129-31. [HepatMon]
  162. Alavian SM, Kafaee J, Yektaparast B, Hajarizadeh B, Doroudi T. The efficacy of blood donor screening in reducing the incidence of hepatitis C virus infection among thalassemic patients in Iran. Transfusion Today. 2002;53:3-4.
  163. Alavi SM, E'temadi A. HIV/HBV, HIV/HCV and HIV/HTLV-1 co-infection among injecting drug user patients hospitalized at the infectious disease ward of a training hospital in Iran. Pak J Med Sci. 2007;23(4):510-3. [Popline]
  164. Mirmomen SH, Ghofrani H, Ebrahimi Daryani N, Niknami H. [Frequency and clinical importance of hepatitis C in thalassemic patients]. Govaresh. 2001;6(33-34):120-4.
  165. Merat S, Sohrabpoor AA, Khaleghi S, et al. Peginterferon alfa-2a and ribavirin in patients with chronic hepatitis C and inherited bleeding disorders. Hepat Mon. 2004;4(7):59-64. [HepatMon]
  166. Naghavi N, Samimirad K, Salehi M, Shanesazzadeh M, H.Hoorfar, Nategh R. Study of hepatitis C frequency with the method of RT-PCR in thalassemic and hemophiliac patients of Isfahan province, 2005. Iran J Infect Dis Trop Med. 2007;11(35):33-9.
  167. Mohammad-Alizadeh AH, Rezazadeh M, Ranjbar M, et al. [Frequency of hepatitis B and C and their relation with factor VIII inhibitor in hemophiliac patients of Hamedan province, 2004]. Research in Medicine, J Shahid Beheshti Sch Med. 2006;30(2):119-23. [Pejouhesh]
  168. Gachkar L, Taremi M, Khoshbaten M, et al. [Frequency of antibodies to hepatitis E virus among male blood donors in Tabriz]. Blood, Sci J Iranian Blood Transfus Org Res Cent. 2005;2(5):157-62. [Blood journal]
  169. Kompani F, Rezayi N. [Study of hepatitis C prevalence and its association with glucose tolerance disorder and diabetes mellitus in patients with beta-thalassemia major]. J Kordestan Univ Med Sci. 2008;12:45-52. [IranMedex]
  170. Kazeminejad V, Azarhoosh R, Moulana AA, Dehbashi GR. [Frequency of hepatitis B, C and HIV in blood donors and patients referring to Gorgan Blood Transfusion Organization (2003)]. J Gorgan Univ Med Sci. 2005;7(1):84-6. [GOUMS]
  171. Kazerani H. [Epidemiologic study of HCV, HBV and HIV positive in surgery-undergone patients and cardiac invasions in Imam Ali hospital in Kermanshah]. J Kordestan Univ Med Sci. 2007;11:42-7. [IranMedex]
  172. Alavian SM, Einollahi B, Hajariazdeh B, Bakhtiari S, Nafar M, Ahrabi S. [Prevalence and risk factors of hepatitis C in hemodialysis patients]. Pajoohandeh. 2003;8(5):315-9. [Pajoohandeh]
  173. Alavian SM, Manzoori-Joybari H, Asari SH, Moghani Lankarani M. [Is a war injury history a risk factor for HDV infection?]. J Mil Med. 2005;7(2):95-9. [MilMed]
  174. Alavian SM, Rajai M, Saeedi-Arab M, et al. [Prevalence of HBV and HCV in disabled patients of " 27 Hazrate Rasool" corps and ground force of Guardians of the Islamic Revolution Army] . J Mil Med. 2002;4(1):7-10. [MilMed]
  175. Alavian S, M,, Kafaei J, Yektaparast B, et al. [The prevalence of Hepatitis B and C among Thalassemia major patients in Qazvin]. Kowsar Med J. 2002;4(7):325-19. [Kowsar]
  176. Abdi J, Mo'azzami-Goodarzi HR. [Prevalence of HBcAb among the HBsAg negative first-time blood donors in Khorramabad and Borujerd blood centers]. Blood, Sci J Iranian Blood Transfus Org Res Cent. 2008;4(5):323-9. [Blood Journal]
  177. Taheri-Azbarmi Zn, Noori Sn, Joukar F, et al. [Transfusion transmitted diseases in Rasht blood donors]. Blood, Sci J Iranian Blood Transfus Org Res Cent. 2008;4(5):337-43. [Blood Jouranl]
  178. Sharifi-Mood B, Metanat M, Ghaedi HR. [Frequency of blood born viruses transmission in the people with tatoo in Zahedan (2004-2006)]. Iran J Infect Dis Trop Med. 2007;12(37):67-9.
  179. Salman-Roghani H. [Study of HCVAb, HBCAb and HBSAb frequency in volunteers of seronegative blood donation for HBS-Ag]. J Yazd Univ Med Sci. 2005;12(4):10-6.
  180. Zakizadeh M, Sadeghian A, Bagheri-Nesami M, et al. [Seroprevalence and risk factors of hepatitis C in addicted prisoners of Khazarabad prison in Sari]. J Yazd Univ Med Sci. 2006;14(2):29-37. [PJM]
  181. Razavioon T. [Prevalence of hepatitis B and C and HIV I & II infections in Fereidoonkenar and Babolsar regions]. Laboratory News. 2006;35:18.
  182. Rostami-Jalilian M, Omidgha'emi M, Kasa'ian N. [Study of hepatitis B and C relation with deep venous thrombosis (DVT) in injection drug users]. J Mil Med. 2006;8(1):78-81. [MilMed]
  183. Dadgaran SA. [Prevalence and risk factors of hepatitis C virus among hemodialysis patients]. J Guilan Univ Med Sci. 2005;55:76-86.
  184. Habibzadeh Sh, Davarnia B, Bazaz Ataei A, Bagherzadeh S, Hamidkholgh GhR. [Epidemiological evaluation of transfusion transmitted diseases in Ardabil in Tasoua and Ashoura (2003)]. Blood, Sci J Iranian Blood Transfus Org Res Centr. 2005;1(2):55-60. [Blood Journal]
  185. Chamani L, Zera'ati H, Asgari S, Shabestari O, Soltan-Ghorayi H, Habibzadeh-Shoja'i A. Seroepidemiologic study of CMV, toxoplasma and hepatitis B and C in clients of Avicenna Infertility Clinic. Iran J Infect Dis Trop Med. 2007;11(35):59-63.
  186. Amini Kafi-Abad S, Talebian A, Ranjbar F, Moghtadayi M, Sobhani M, Sami'i S. [Screening of donated blood for hepatitis C infection in Iranian blood donors: A preliminary study]. Blood, Sci J Iranian Blood Transfus Org Res Cent. 2005;2(3):13-22. [Blood Journal]
  187. Amirzargar AA, Shahrokhi N, Hajia M, Farzanekhah M. Study of HCV positive patients and identified genotypes frequency in 2003-2004 with PCR. Lab Diag. 2005;41:5-8.
  188. Emam-Ghoreyshi F, Fathi GA, Mohtashami A. [Evaluation of demographic characteristics and hepatitis B, C and HIV prevalence among blood donors in Jahrom]. Blood, Sci J Iranian Blood Transfus Org Res Cent. 2006;2(7):373-8. [Blood Journal]
  189. Aghajanipoor K, Zandieh T. [Seroepidemiological investigation of Hepatitis B, C and HIV virus in safe blood donors of Babol Blood Transfusion Center]. Blood, Sci J Iranian Blood Transfus Org Res Cent. 2006;2(7):339-41. [Blood Journal]
  190. Afzali H, Taghavi-Ardakani A, Vali G, R. [Seroepidemiology of Hepatitis B and C in blood donors in Kashan, 1996-2001]. Feyz, J Kashan Univ Med Sci. 2002;23:43-51. [KAUMS]
  191. Azarkar Z, Sharifzadeh G, Miraki MA. [Prevalence of Hepatitis B and C and HIV in prisonned people in Birjand]. J Birjand Univ Med Sci. 2007;14(2):50-6. [IranMedex]
  192. Alavian SM, Hajariazdeh B, Doroodi T, et al. [Study of hepatitis B and C prevalence in thalassemic major patients of Qazvin province]. Kowsar Med J. 2003;7(4):319-25. [Kowsar]
  193. Ameen R, Sanad N, Al-Shemmari S, et al. Prevalence of viral markers among first-time Arab blood donors in Kuwait. Transfusion. 2005;45(12):1973-80. [PubMed]
  194. Daw MA, Elkaber MA, Drah AM, Werfalli MM, Mihat AA, Siala IM. Prevalence of hepatitis C virus antibodies among different populations of relative and attributable risk. Saudi Med J. 2002;23(11):1356-60. [PubMed]
  195. Ali SA, Donahue RM, Qureshi H, Vermund SH. Hepatitis B and hepatitis C in Pakistan: prevalence and risk factors. Int J Infect Dis. 2009;13(1):9-19. [PubMed]
  196. Sandesh K, Varghese T, Harikumar R, et al. Prevalence of Hepatitis B and C in the normal population and high risk groups in north Kerala. Trop Gastroenterol. 2006;27(2):80-3. [PubMed]
  197. Erden S, Buyukozturk S, Calangu S, Yilmaz G, Palanduz S, Badur S. A study of serological markers of hepatitis B and C viruses in Istanbul, Turkey. Med Princ Pract. 2003;12(3):184-8. [NCBI]
  198. Lehman EM, Wilson ML. Epidemiology of hepatitis viruses among hepatocellular carcinoma cases and healthy people in Egypt: a systematic review and meta-analysis. Int J Cancer. 2009;124(3):690-7. [PubMed]
  199. Xia X, Luo J, Bai J, Yu R. Epidemiology of hepatitis C virus infection among injection drug users in China: systematic review and meta-analysis. Public Health. 2008;122(10):990-1003. [PubMed]
  200. Stvilia K, Tsertsvadze T, Sharvadze L, et al. Prevalence of hepatitis C, HIV, and risk behaviors for blood-borne infections: a population-based survey of the adult population of T'bilisi, Republic of Georgia. J Urban Health. 2006;83(2):289-98. [NCBI]
  201. Armstrong GL, Wasley A, Simard EP, McQuillan GM, Kuhnert WL, Alter MJ. The prevalence of hepatitis C virus infection in the United States, 1999 through 2002. Ann Intern Med. 2006;144(10):705-14. [PubMed]
  202. Galetskii SA, Seniuta NB, Syrtsev AV, et al. [Analysis of some viral infections, transmitted by parenteral and sexual routes, in the Republic of Azerbaijan]. Vopr Virusol. 1999;44(5):232-6. [PubMed]
  203. Brito VO, Parra D, Facchini R, Buchalla CM. [HIV infection, hepatitis B and C and syphilis in homeless people, in the city of Sao Paulo, Brazil]. Rev Saude Publica. 2007;41 Suppl 2:47-56. [PubMed]
  204. Mateu-Gelabert P, Treloar C, Calatayud VA, et al. How can hepatitis C be prevented in the long term? Int J Drug Policy. 2007;18(5):338-40. [NCBI]
  205. Alavian SM. We Need a New National Approach to Control Hepatitis C: It is Becoming too Late. Hepat Mon. 2008;8(3):1-3. [HepMon]
  206. Dodd RY, Notari EPt, Stramer SL. Current prevalence and incidence of infectious disease markers and estimated window-period risk in the American Red Cross blood donor population. Transfusion. 2002;42(8):975-9. [PubMed]
  207. Chiavetta JA, Escobar M, Newman A, et al. Incidence and estimated rates of residual risk for HIV, hepatitis C, hepatitis B and human T-cell lymphotropic viruses in blood donors in Canada, 1990-2000. Can Med Assoc J. 2003;169(8):767-73. [NCBI]
  208. Offergeld R, Faensen D, Ritter S, Hamouda O. Human immunodeficiency virus, hepatitis C and hepatitis B infections among blood donors in Germany 2000-2002: risk of virus transmission and the impact of nucleic acid amplification testing. Euro Surveill. 2005;10(2):8-11. [NCBI]
  209. Velati C, Fomiatti L, Baruffi L, Romano L, Zanetti A. Impact of nucleic acid amplification technology (NAT) in Italy in the three years following implementation (2001-2003). Euro Surveill. 2005;10(2):12-4. [PubMed]
  210. Gonzalez M, Regine V, Piccinini V, Vulcano F, Giampaolo A, Hassan HJ. Residual risk of transfusion-transmitted human immunodeficiency virus, hepatitis C virus, and hepatitis B virus infections in Italy. Transfusion. 2005;45(10):1670-5. [PubMed]
  211. Prati D. Transmission of hepatitis C virus by blood transfusions and other medical procedures: a global review. J Hepatol. 2006;45(4):607-16. [PubMed]
  212. Liu P, Shi ZX, Zhang YC, Xu ZC, Shu HS, Zhang XY. A prospective study of a serum-pooling strategy in screening blood donors for antibody to hepatitis C virus. Transfusion. 1997;37(7):732-6. [NCBI]
  213. Mujeeb SA, Hafiz A. Low-cost screening of blood for HCV infection in the developing world. Vox Sang. 1998;74(3):210. [PubMed]
  214. Thakral B, Marwaha N, Chawla YK, et al. Prevalence & significance of hepatitis C virus (HCV) seropositivity in blood donors. Indian J Med Res. 2006;124(4):431-8. [PubMed]
  215. Candotti D, Sarkodie F, Allain JP. Residual risk of transfusion in Ghana. Br J Haematol. 2001;113(1):37-9. [InterScince]
  216. Kamel MA, Ghaffar YA, Wasef MA, Wright M, Clark LC, Miller FD. High HCV prevalence in Egyptian blood donors. Lancet. 1992;340(8816):427. [PubMed]
  217. Rezvan H, Abolghassemi H, Kafiabad SA. Transfusion-transmitted infections among multitransfused patients in Iran: A review. Transfus Med. 2007;17(6):425-33. [Scopus]
  218. Silva LK, Silva MB, Rodart IF, et al. Prevalence of hepatitis C virus (HCV) infection and HCV genotypes of hemodialysis patients in Salvador, Northeastern Brazil. Braz J Med Biol Res. 2006;39(5):595-602. [PubMed]
  219. Barril G, Traver JA. Decrease in the hepatitis C virus (HCV) prevalence in hemodialysis patients in Spain: effect of time, initiating HCV prevalence studies and adoption of isolation measures. Antivir Res. 2003;60(2):129-34. [PubMed]
  220. Alavian SM. A shield against a monster: Hepatitis C in hemodialysis patients. World J Gastroenterol. 2009;15(6):641-6. [NCBI]
  221. Dentico P, Buongiorno R, Volpe A, et al. Prevalence and incidence of hepatitis C virus (HCV) in hemodialysis patients: study of risk factors. Clin Nephrol. 1992;38(1):49-52. [PubMed]
  222. Alavian SM, Tabatabaei SV. RE: Serum viral markers in Iranian patients with congenital bleeding disorder. Ann Saudi Med. 2009;29(4):322. [PubMed]
  223. Alavian SM. Triangular Clinics: The Way of The Future. Hepat Mon. 2005;5(3):51-. [HepatMon]