Molecular and serological comparison study for diagnosis of hepatitis c and B infection in haemodialysis patients in Dhi-qar province/Iraq

Viral hepatitis remains a major public health concern worldwide. Hepatitis C virus (HCV) and hepatitis B virus (HBV) infections are among the most prevalent infectious diseases globally. This issue becomes particularly significant in patients undergoing dialysis due to chronic renal failure, as these individuals are at high risk of acquiring HBV and HCV infections. This study is a descriptive cross-sectional investigation involving 154 patients undergoing dialysis at the Central Hemodialysis Unit of Al-Hussein Teaching Hospital in Dhi-Qar Province, Iraq. Serum samples were analyzed using specific ELISA kits to detect hepatitis B surface antigen (HBsAg) and anti-HCV antibodies. Findings were confirmed using PCR analysis for both HCV and HBV. HCV genotyping was conducted using a genotyping kit containing genotype-specific primers. Among the 154 participants, 95 (61.69%) were male and 59 (38.31%) were female. Age groups were classified as follows: <20 (19.48%), 20–29 (17.53%), 30–39 (22.08%), 40–49 (22.73%), and >50 (18.18%). Anti-HCV seropositivity was observed in 100 patients (64.94%), while HBsAg positivity was found in 54 patients (35.06%). HBV-DNA PCR confirmed positivity in 54 patients, and HCV-RNA PCR detected active infection in 88 patients. Among the 88 HCV-positive cases, three genotypes were identified: GT 1a (32 patients/36.4%; 20 males, 12 females), GT 1b (32 patients/36.4%; 19 males, 13 females), and GT 4 (24 patients/27.3%; 15 males, 9 females). The calculated p-value was 0.084, indicating no statistically significant difference between genders. The disparity between ELISA and PCR results emphasizes the importance of using both methods in combination for accurate diagnosis. Of the 100 patients who tested positive by anti-HCV ELISA, only 88 were confirmed to have active infection via HCV-RNA PCR. This suggests that some patients may have cleared the infection but still retain circulating antibodies. Thus, relying solely on ELISA could lead to misinterpretation of the current health status. In contrast, results for HBV detection showed consistency between ELISA and PCR, with both tests identifying 54 positive cases. This consistency suggests that ELISA is a reliable method for detecting active HBV infections in this patient group. However, sensitivity and specificity of diagnostic tests may vary depending on patient populations and clinical conditions In conclusion, the combined use of ELISA and PCR is essential for accurate and reliable diagnosis of HCV and HBV infections, particularly in high-risk groups such as hemodialysis patients.