Dear Editor,
We read with interest the published article by Nikbakht et al. in your journal recently (1). The study reported the low prevalence of hepatitis B virus (HBV) infection among 712 infertile couples in Ahvaz, but higher hepatitis C virus (HCV) infection than the previous reported studies from Iran (2). Although the study could determine a complete set of infertile patients, it could not be extended to the general population since it was not the desired representative of general population as well.
Defining the main risk factors for finding the routs of transmission is of utmost importance when studying the HBV and HCV infections in the communities (3). Unfortunately Risk factors are not discussed in the mentioned study may be due to matters of retrospective design of the study. Furthermore, the study could not succeed to define the relationship between age groups among positive cases. Despite the fact that lots of similar studies in the world reported the male dominance in HCV and HBV patients, the current study declared inverse relationship (female dominance: 6 females versus 5 males in HBV and 6 females versus 3 males in HCV). According to prevalence of HBV and HCV in the normal population, strangely HCV infection is reported similar to HBV infection which should be considered for readers. Alavian SM et al already stated that HCV infection as an emerging disease in Iran should be considered carefully (4) which probably due to changing of risk factors in Ahvaz and altering the harmony of causes in the region it could be explained. Another strong point of the study is reporting the HBV infection in age groups lower than 18 years which is based on implementation of national vaccination program since 1993 for all neonates in Iran (5).
Although drug abuse has been the major routes of HCV transmission in Iran, the current study has not studied the role of this important risk factor. The importance of studying the role of history of IDUs is so high in every epidemiological studies and as the main risk factor for HCV especially in Iran should be considered since it could lead to a higher prevalence of HCV infection in each population (6, 7). For instance in a previous study in Ahvaz among IDUs showed that the HCV rate is 30.9% in comparison with HBV which was reported in 3.6% of patients (8).
