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Hepatitis C virus (HCV) is a leading cause of chronic liver disease. The prevalence in blood donors in the USA and West Europe is around 0.3%. However, there are few studies performed in East Europe. We have studied the prevalence of hepatitis C virus infection and risk factors associated with it in the Russian Republic of Daghestan.We included 10,682 volunteer blood donors, 267 commercial blood donors, 97 high risk patients (22 haemophiliacs, 41 in haemodialysis program and 34 parenteral drug addicts), and 87 patients with chronic liver disease (61 chronic hepatitis, 20 cirrhosis and 6 hepatocellular carcinoma). Antibodies against HCV were detected by second generation ELISA.0.93% of volunteer blood donors were found to be HCV reactive. Factors with stronger association with seropositivity were previous blood transfusion and parenteral drug addiction. 66% of seropositive blood donors had an elevated level of ALT. Alcohol use correlated with more marked deterioration in liver function tests. 7.5% of commercial blood donors were seropositive. Prevalence in high risk patients and in patients with chronic liver disease was very high (50–80% and 40–50%, respectively).the Russian Republic of Daghestan has one of the lowest rates of HCV infection in East Europe. Commercial blood donors have a very high prevalence of HCV infection. The risk factors associated with HCV infection are similar to those found in other epidemiological studies.