What does this research mean for the field?

Among suspected individuals in Baghdad, Iraq, hemoglobinopathies have a prevalence of 23.5%, with the β-thalassemia trait being the most common, and high-performance liquid chromatography (HPLC) remains an effective frontline diagnostic tool for their detection. Novelty: ClaimNovelty.INCREMENTAL. Consensus alignment: ConsensusAlignment.NEUTRAL.

What question did this study set out to answer?

The study aims to determine the frequency and distribution of hemoglobinopathies detected by HPLC in a tertiary center.

June 14, 2026Open Access

A 2-year Review of Hemoglobinopathies using High-performance Liquid Chromatography at a Single Tertiary Center in Baghdad, Iraq

Key Points

The study aims to determine the frequency and distribution of hemoglobinopathies detected by HPLC in a tertiary center.
Retrospective observational design reviewing 2,558 suspected β-thalassemia and hemoglobinopathy cases.
Inclusion required complete laboratory data, including CBC and HPLC results.
Cases were classified based on HPLC patterns into normal or abnormal, and further into carrier states or diseases.
602 (23.5%) cases showed abnormal HPLC patterns, with β-thalassemia trait being the most frequent at 19.7%.
Most diagnoses occurred in individuals aged ≥12 years, while severe disorders presented in early childhood (P = 0.003).
86.9% of patients had low Hb levels, with the lowest mean Hb in β⁰-thalassemia major.

Abstract

Abstract: BACKGROUND: Hemoglobinopathies are among the most common inherited disorders worldwide and represent a significant health burden in Iraq. High-performance liquid chromatography (HPLC) is considered a reliable and fast method for screening and diagnosis of β-thalassemia and hemoglobin variants. This study aimed to determine the frequency and pattern of hemoglobinopathies detected by HPLC and to evaluate their distribution according to age, sex, and Hb level. MATERIALS AND METHODS: This retrospective observational study was conducted at Imamein Kadhimein Medical City, Baghdad, Iraq, from November 2023 to December 2025. A total of 2,558 suspected cases of β-thalassemia trait and other hemoglobinopathies were reviewed. Inclusion required the availability of complete laboratory data, including complete blood count (CBC) and HPLC. Patients with incomplete laboratory data were excluded from the study. Based on CBC and HPLC findings, in addition to supplementary tests, cases were initially classified into normal and abnormal Hb HPLC patterns. Cases with abnormal Hb patterns were further categorized into carrier states, disease, or syndrome conditions. RESULTS: Among 2558 cases, 602 (23.5%) showed abnormal HPLC patterns. β-thalassemia trait was the most frequent diagnosis (19.7%), followed by sickle cell trait (1.3%), among total cases. Majority of the trait conditions were diagnosed in participants aged ≥12 years, while severe disorders presented mainly in early childhood ( P = 0.003). Females represented 58.5% of cases ( P = 0.122). Most of the patients (86.9%) had low Hb levels, with the lowest mean Hb observed in β⁰-thalassemia major. CONCLUSION: This study represents one of the main single-center HPLC-based Hb analyses for the diagnosis of hemoglobinopathy and demonstrates a substantial prevalence among suspected individuals, with β-thalassemia trait representing the predominant finding in our center. Thus, HPLC remains an effective frontline diagnostic tool for detecting both common and rare Hb variants, supporting early identification and appropriate clinical management.

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