Hepatitis C virus (HCV) infection has been recognized as an emerging problem in dialysis patients and its prevalence varies considerably among different areas of the world. The prevalence of HCV infection in hemodialysis (HD) patients and its associated risk factors is not well documented in our country. We therefore performed this study aiming to discuss prevention of further transmission of HCV infection among our patients. Between September 2003 and September 2005, 169 patients with end-stage renal failure on HD at the Renal Transplant Center, Medical City Teaching Hospital, Baghdad, were involved in this prospective study. There were 102 (60.4%) males, and 67 (39.6%) females, with age ranging from 14-67 years. Anti-HCV antibodies were positive in 12 of these patients (7.1%). Female gender, age >or = 60 years, dialysis duration < or = six months, history of having received blood transfusion(s), and < 9 hours per week of HD were significant predictors of anti-HCV positivity. We conclude that adherence to universal infection precautions, regular HCV screening of transfusions and of patients on HD and the use of separate machines for those who are anti-HCV positive, are important factors. To further reduce the prevalence in our patients, erythropoietin should replace blood transfusions as also testing for HCV RNA using polymerase chain reaction before starting HD.