Controversial Report Regarding Seroprevalence of Hepatitis B and C Viruses Among Hemodialysis Patients In Kerman Province, South-East Iran

which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited. We read carefully the article by Zehedi et al., (1) which determined the prevalence of hepatitis B (HBV), C (HCV), and D (HDV) viruses as well as the human immunodeficiency virus (HIV) in hemodialysis (HD) patients within Kerman province, located in southeast region of Iran (1). It is now well established that the prevalence of various types of hepatitis viruses among HD patients is higher than the general population (2). According to the important role playing by viral infections in the pathogenesis of HD health status, the prevalence of the viral infections was evaluated in the HD patients by the authors. They have reported that the prevalence of HBV and HCV was moderate to low, while, HIV-Ab and HDV-Ab were both negative in all patients of Kerman province (1). The Authors of this letter believe that zahedi and co-worker`s results need to be interpreted more cautiously, because possible con-founders and limitations of their study need to be considered. Zahedi et al., have evaluated the prevalence of HBV and also HCV using ELISA dependent technique and studied the HCV-RNA and HBV-DNA in the HCV-Ab and HBsAg positive patients, respectively, via Real-Time PCR. Based on the previous reports, it is obvious that a proportion of the HCV infected patients are unable to produce detectable antibody against HCV due to several reasons including humeral immunodeficiency (3), impaired Th2 system (4) as well as insufficient stimulation by innate immunity (5, 6). Additionally, the infected patients need enough time from the initiation point of the infection to produce anti-HCV antibodies (latent phase). Therefore, considerable cases of HCV infected individuals have been missed where merely ELISA technique is used to detect HCV infection. In contrast with Zahedi et al.' results, our