Epidemiology of Hepatitis C Virus in Iran

In Iran, the prevalence of hepatitis C virus (HCV) infection is relatively low according to the population-based epidemiological studies. However, the epidemiology of HCV is changing and the rate of HCV infection is increasing due to the growth in the number of injecting drug users in the society. In addition, a shift has occurred in the distribution pattern of HCV genotypes among HCV-infected patients in Iran. Genotype 1a is the most prevalent genotype in Iran, but in recent years, an increase in the frequency of 3a and a decrease in 1a and 1b have been reported. These variations in the epidemiology of HCV reflect differences in the routes of transmission, status of public health, lifestyles, and risk factors in different groups and geographic regions of Iran. Health policy makers should consider these differences to establish better strategies for control and prevention of HCV infection. Therefore, this review was conducted to present a clear view regarding the current epidemiology of HCV infection in Iran.

Table 1

Prevalence of hepatitis C virus among blood donors in Iran

Author	Year of study	City or province	Location	No. of participants	No. of positive samples	Prevalence	Test	Ref.
Taheri Azbarmi	2003-2005	Rasht, Gilan province	North	49820	91	0.18%	ELISA and RIBA	[36]
Mansour-Ghanaei	1998-2003	Gilan	North	221508	3603	1.62%	ELISA	[37]
					709	0.32%	RIBA
Bani Aghil	2006-2008	Golestan	North-East	128198	161	0.12%	ELISA and immunoblot	[38]
Khedmat	2003-2005	Tehran	North-Center	1004889	21390	2.10%	ELISA	[39]
					1005	0.10%	RT-PCR
Attarchi	2003-2004	Tehran	North-Center	26645	42	0.20%	ELISA and RIBA	[40]
Khedmat	2005-2006	Tehran	North-Center	318029	323	0.09%	ELISA, immunoblot and RT-PCR	[35]
Bozorgi	2002-2004	Qazvin	West-Center	48116	73	0.15%	ELISA and RIBA	[41]
Mahdaviani	2004	Arak	West-Center	11615	81	0.70%	ELISA	[42]
					33	0.20%	RIBA
Bozorgi	2009	Qazvin	West-Center	20591	328	1.59%	ELISA	[43]
					35	0.17%	HCV confirmatory tests (ND)
Afzali	1996-2001	Kashan	Center	43731	477	1.10%	ELISA	[44]
Moniri	2001-2002	Kashan	Center	600	3	0.50%	ELISA	[45]
Karimi	2004-2006	Shahr-e Kord	Central	35124	70	0.20%	ELISA and immunoblot	[46]
Masaeli	2002-2003	Isfahan	Center	29458	24	0.27%	ELISA and RIBA	[47]
Esmaieli	2006-2007	Bushehr	South	20294	42	0.20%	ELISA and immunoblot	[48]
Ghavanini	1998	Shiraz	South	7897	47	0.59%	ELISA and immunoblot	[49]
Emamghorashi	2001-2003	Jahrom	South	3000	9	0.30%	ELISA and immunoblot	[50]
Kasraian	2002-2005	Shiraz	South	507531	710	0.14%	ELISA	[51]
Kasraian	2007-2008	Shiraz	South	93987	203	0.21%	ELISA and RIBA	[52]
Delavari	2003	Kerman	South-East	15252	60	0.39%	ELISA	[53]
Tajbakhsh	2004	Shahr-e kord	West	11472	69	0.60%	ELISA	[54]
Doosti	2003-2004	Shahrekord	West	11200	76	0.67%	ELISA	[55]
						0.59%	immunoblot
						0.41%	RT-PCR
Ghafouri	2006-2009	South Khorasan	East	42652	31	0.07%	ELISA	[56]
					13	0.03%	RIBA

ND: Not defined; ELISA: Enzyme linked immunosorbent assay; RT-PCR: Reverse transcriptase polymerase chain reaction; RIBA: Recombinant immunoblot assay.

Table 2

Prevalence of hepatitis C virus among general population in Iran

Author	Year of study	City or province	Location	No. of participants	No. of positive samples	Prevalence	Test	Ref.
Zamani	2008-2011	Amol, Mazandaran	North	6145	12	0.20%	ELISA	[60]
					5	0.08%	RIBA
					3	0.05%	RT-PCR
Mansour-Ghanaei	2003	Gilan	North	383	9	2.30%	ELISA	[61]
					5	1.30%	RT-PCR
Shakeri	2010-2011	Mashhad	North-East	3870	8	0.20%	ELISA	[62]
					5	0.13%	RT-PCR
Ghadir	2006	Golestan	North-East	2123	56	2.60%	ELISA	[63]
					22	1.00%	RIBA
Merat	2006	Golestan	North-East	1895	18	1.00%	ELISA and RIBA	[58]
Merat	2006	Tehran	North-Center	2326	8	0.30%	ELISA and RIBA	[58]
Merat	2006	Hormozgan	South	1463	24	1.60%	ELISA and RIBA	[58]
Motlagh	2001	Ahvaz	South-West	80	5	6.25%	ELISA	[64]
					0	0.00%	Immunoblot
Nikbakht	2007-2008	Ahvaz	South-West	712	9	0.63%	ELISA	[65]
Moradi	2001-2002	Saravan,	South-East	365	3	0.80%	ELISA	[66]
		Sistan and
		Baluchestan
Sayad	2006	Kermanshah	West	1721	15	0.87%	ELISA, immunoblot and RT-PCR	[67]
Mohebbi	2007-2008	Lorestan	West	827	2	0.20%	ELISA	[68]

ELISA: Enzyme linked immunosorbent assay; RT-PCR: Reverse transcriptase polymerase chain reaction; RIBA: Recombinant immunoblot assay.

Table 3

Prevalence of hepatitis C virus among injecting drug users in Iran

Author	Year of study	City or province	location	No. of participants	No. of positive samples	Prevalence	Test	Ref.
Mohtasham Amiri	2003	Gilan	North	81	72	88.9%	ELISA	[72]
Rahimi-Movaghar	2006-2007	Tehran	North-Center	895	309	34.5%	ELISA	[73]
Hosseini	2006	Tehran	North-Center	417	334	80.0%	ELISA	[74]
Zali	1995	Tehran	North-Center	402 (Male imprisoned IDUs)	182	45.3%	ELISA, RIBA	[75]
Zamani	2004	Tehran	North-Center	202	105	52.0%	Particle Agglutination (PA) assay	[76]
Hajinasrollah	2005	Tehran	North-Center	65	11	17.0%	ELISA	[77]
Amin-Esmaeili	2006-2007	Tehran	North-Center	895	309	34.5%	ELISA	[78]
Nokhodian	2008-2009	Isfahan	Center	531	250	47.1%	ELISA	[79]
Zamani	2008	Isfahan	Center	117	71	60.7%	EIA	[80]
Kassaian	2009	Isfahan	Center	943	392	41.6%	ELISA	[81]
Fadaei Nobari	2011	Isfahan	Center	1747	595	34.0%	ELISA	[82]
Sofian	2009	Arak, Markazi	West-Center	153 (Male IDUs)	91	59.5%	ELISA	[83]
Ramezani	2012	Arak	West-Center	100 (Male IDUs)	56	56.0%	ELISA	[84]
Honarvar	2012-2013	Shiraz	South	569 (High risk groups)	109	19.1%	ELISA and immunoblot	[70]
				233 (IDUs)	94	40.3%
				336 (non-IDUs)	15	4.4%
Davoodian	2002	Bandar Abbas, Hormozgan	South	249	163	64.8%	ELISA	[85]
Sarkari	2009-2010	Kohgiloyeh and Boyerahmad	South-West	158	67	42.4%	ELISA	[86]
Imani	2004	Shahr-e Kord	Sout-West	133	15	11.3%	ELISA	[87]
Alavi	2002-2006	Ahvaz	South-West	333	103	30.9%	ND	[88]
Mohammad Alizadeh	2002	Hamadan	West	149 (IDUs Prisoners)	47	31.5%	ELISA, immunoblot	[89]
Keramat	2005-2007	Hamadan	West	379 (High risk groups)	135	35.6%	ELISA, immunoblot	[90]
				199 (IDUs)	126	63.3%

IDUs: Injecting drug users; ND: Not defined; ELISA: Enzyme linked immunosorbent assay; RIBA: Recombinant immunoblot assay.

Table 7

Prevalence of hepatitis C virus among HIV-positive patients in Iran

Author	Year of study	City or province	Location	No. of participants	No. of positive samples	Prevalence	Test	Ref.
Babamahmoodi	2008-2010	Mazandaran	North	80	27	33.8%	ELISA	[173]
Ramezani	1999-2004	Tehran	North-Center	95	65	68.0%	ELISA	[167]
SeyedAlinaghi	2004- 2005	Tehran	North-Center	201	135	67.2%	ELISA	[170]
Ataei	1998-2007	Isfahan	Center	130	100	77.0%	ELISA and RIBA	[168]
Davarpanah	2006-2007	Shiraz	South	226	200	88.5%	ELISA	[166]
					196	86.7%	RIBA
					59	26.1%	RT-PCR
Khosravi		Fars	South	101	87	86.1%	ELISA	[172]
Alipour	2011	Shiraz	South	1444	1132	78.4%	ELISA	[169]
Davoodian	2002	Bandar Abbas and Roodan	South	38	35	94.0%	ELISA	[85]
Zahedi	2011	Kerman	South-East	165	122	73.9%	ELISA	[165]
Sharifi-Mood	2000-2005	Zahedan	South-East	52	6	11.5%	ND	[162]
Alavi	2001-2003	Ahvaz	South-West	104	77	74.04%	ELISA	[171]
Saleh	2013	Khorramabad, Lorestan	West	103	23	22.3%	ELISA	[174]
Mohammadi	2007-2008	Lorestan	West	391	282	72.0%	ELISA	[163]

ND: Not defined; ELISA: Enzyme linked immunosorbent assay; RT-PCR: Reverse transcriptase polymerase chain reaction; RIBA: Recombinant immunoblot assay.

Full article at:  http://goo.gl/ZZadhB

By: Taherkhani R1, Farshadpour F1.

• 1Reza Taherkhani, Fatemeh Farshadpour, Department of Microbiology and Parasitology, School of Medicine, Bushehr University of Medical Sciences, Bushehr 7514633341, Iran.  

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