The trends of transfusion-transmitted infection prevalence in Iranian blood donations suggest that most of the safety measures employed in recent years in Iran have been effective.

Candidate blood donors in Ghana are frequent carriers of hepatitis B virus (HBV). A comparative study of 117 donor samples including 46 with alanine aminotransferase (ALT) > or = 60 IU/L and 71 with < or =40 IU/L level was undertaken. S and the basic core promoter-precore regions (BCP/PC) sequencing was used to identify genotypes and variants relevant to HBV natural history, respectively. Age, viral load, HBe status were correlated with molecular data. HBV genotype E (87%) was dominant with little genotypes A (10%) and D (3%). Comparing individuals with or without liver disease, an association between liver disease and older age (P = 0.004) and higher viral load (P = 0.002) whether as a whole population or only genotype E was found. Compared with a commercial assay, BCP/PC sequencing had lower sensitivity to detect mixtures of wild-type and variant viruses but detected BCP deletions. BCP 1762/1764 variants were positively correlated with older age (P < 0.0001) and elevated ALT levels (P = 0.01). PC 1896 stop codon was marginally correlated with viral load (P = 0.09). HBV genotype E infection natural history appears different from genotypes B and C prevalent in Asia. Donors with liver disease being older, with higher viral load and higher BCP variant proportion may be at higher risk of cirrhosis and hepatocellular carcinoma.

We found the prevalence of HCV infection in Iran to be higher than previous estimates. It appears that the rate is rising, and in the future, hepatitis C will replace hepatitis B as the most common cause of chronic viral liver disease in Iran.

Transfusion-transmitted infections (TTI) continue to be a major challenge for Blood transfusion organizations across the world. The problem is more serious in the developing countries with lower economic means. Multitransfused patients (MTPs) in these countries are at higher risk of infection, and studies of infection in these patients can be a useful index for examining the blood safety filters in place. The present article reviews the situation in Iran, where prevalence of the major viruses of concern, namely, hepatitis B virus, hepatitis C virus (HCV) and human immunodeficiency virus, studied in these patients is reported over a 9-year period. It is demonstrated that HCV is the most prevalent TTI and remains a major health problem for these patients.

The rate of prevalence of H. pylori infection was higher than developed countries. Low socioeconomic status, poor sanitary indications, and crowded families in childhood were related to high prevalence of H. pylori infection in Iran. Accordingly, fecal-oral and oral-oral routes could be considered as the main pathways of transmission of H. pylori.

NAFLD is the most common cause of persistently elevated serum ALT level among the general population of Iran.

Iran is a low to medium endemic country for hepatitis B virus (HBV), depending on the region, where genotype D is dominant. Samples from 170 asymptomatic HBsAg-positive blood donors were quantified and the median viral load was 6.7 × 10(2)  IU/ml with 10.6% samples unquantifiable. Fifty complete genome sequences of these strains were characterized. Phylogenetic analysis identified 98% strains as subgenotype D1 and 2% as D2. Deduced serotypes were ayw2 (94%), ayw1 (4%), and adw (2%). The nucleotide diversity of the complete genome subgenotype D1 Iranian strains was limited (2.8%) and comparison with D1 strains from Egypt and Tunisia revealed little variation between strains from these three countries (range 1.9-2.8%). The molecular analysis of the individual genes revealed that the G1896A mutation was present in 86.2% of the strains and in 26 strains (29.9%) this mutation was accompanied by the G1899A mutation. The double mutations A1762T/G1764A and G1764T/C1766G were found in 20.7% and 24.1% of the strains, respectively. The pre-C initiation codon was mutated in five strains (5.8%). One strain had a 2-amino acid (aa) insertion at position s111 and another sP120Q substitution suggesting a vaccine escape mutant.

Assessment of the quality of donor selection and safety of the blood supply can be estimated by monitoring the prevalence of the serologic markers of infectious disease in screening tests. In the present study, changes in rates of hepatitis B virus (HBV) infection are studied in the period 1998-2007 in Iranian Blood Transfusion Organization (IBTO). Prevalence of serological marker of HBV infection [hepatitis B surface antigen (HBsAg)] was evaluated in blood donations in Iran as well as for Fars province representing a low prevalence, and Sistan-Baluchestan (S&B) province as a high prevalence region throughout 1998-2007. For assessing frequency of infection, the prevalence of HBsAg per 100 000 donations and 95% confidential intervals (95% CIs) is calculated. P value is estimated by chi(2) test. A total of 14 599 783 donations were collected during 10 years. The overall HBsAg prevalence rates declined from a 1.79% (1789/100 000 donations) in 1998 to 0.41% (409/100 000 donations) in 2007 in Iran. In Fars province, HBsAg prevalence decreased from 0.89% in 92 999 donations in 1998 to 0.34% in 148 014 donations in 2007 and in S&B province, the rate of HBsAg has gone down from 3.74% in 44 036 donations in 1998 to 1.15% in 56 057 donations in 2007. The frequency of HBV infection entering the blood supply has decreased over this period as a result of improvement in donor recruitment and selection, usage of software in transfusion services and possibly decreasing HBV infection prevalence in general population.