Conceived and designed the experiments: Screenings of such coinfections need to be reinforced to prevent new infections and also reduce further transmission in their community and to others.
HIV and viral hepatitis infections are still the major causes of morbidity and mortality in developing countries, with one billion people directly exposed or at-risk population [ 1 , 2 ]. Annually, approximately two million people die due to AIDS, more than thousands people die from diseases associated with HCV and one million people die as a result of an HBV infection [ 3 β 5 ].
Prevention strategies like public awareness on routes of transmission, free HIV testing and counseling services at public health facilities and correctional institutes like prisoners contributed to this low prevalence.
Screening for HCV and HIV in all blood donors and all blood products have been in place since and respectively. Countrywide harm reduction services including, but not limited to needle exchange programs delivered by centers and drug treatments like methadone maintenance therapy delivered by centers have been implemented by governmental funds [ 7 ]. The government of Iran is committed to provide universal access to HIV prevention free condom, education, HIV testing and antiviral therapy services for all at-risk or affected populations as outlined in the 4 th National AIDS Strategic Plan β19[ 8 ].
These heath policies and interventions aim to reduce the burden of main blood-borne infections in Iran. These coinfections could lead to accelerated chronic hepatitis and liver cancer 11 , which reported as one of the major causes of morbidity and mortality in HIV-infected individuals The most affected population are PWID The trends of HIV and risk behaviors have been studied in several national bio-behavioral surveys [ 11 , 12 ].
