Human papillomavirus genotype prevalence and distribution among Moroccan women

Background:Human papillomavirus (HPV) is the major etiologic agent of invasive cervical cancer, vulvar and vaginal cancer. It has been estimated that, worldwide, 70% of cervical cancers are due to HPV-16 and HPV-18. Malignant transformation appears to require the presence of additional cofactors such as pregnancy, smoking and immunosuppression. The aim of the present study was to determine the prevalence and distribution of HPV genotypes among Moroccan women.  Methods:Between January 1, 2011, and December 31, 2012, 277 cervical samples collected from confirmed women who attended the department of gynecology and obstetrics at Mohamed V Military teaching hospital, Rabat, Morocco, were analyzed in the laboratory of virology for HPV in vitro diagnosis and genotyping and for cytology in laboratory of pathology.Results:High-risk HPV DNA was detected in 101 (36%) samples, with higher prevalence in women ≥45 (43%) years. The overall prevalence of HPV infection and multiple infections in the study samples was 76% and 21%, respectively. The most frequent HPV genotypes were HPV-16 (31%). Human papillomavirus DNA detection was inversely related to maternal age. The risk of HPV infection was significantly reduced in women aged older than 30 years. The history of gynaecological problem showed significant association with the HPV positive test.Conclusion:In Morocco, the diagnosis of cervical lesions rests exclusively on the cytology-based screening that offers substantial protection, although current coverage is low. The introduction of HPV DNA testing in cervical cancer management will greatly benefit early stage HPV detection and help prevent development of cervical lesions and cancer. Screening pregnant women offer a significant opportunity for the Moroccan National Program against cervical cancer to control.  

Dengue fever in Morocco: result of surveillance during the year 2017 and first imported cases

Dengue is a significant mosquito-borne infection in humans, and its worldwide prevalence is rapidly increasing. The vector aedes albopictus has been revealed recently in the town of Rabat. Morocco established a program of active surveillance of dengue fever comprising many hospitals and laboratories across the kingdom. The purpose of this work is to describe the result of the surveillance of the dengue virus (DENV) infection during the year of 2017 among Moroccans and tourists who presented in our hospital with clinical signs of infection and to report the first confirmed positive cases of Dengue.From 20 December 2016 to 20 December 2017, 21 patients were hospitalized for suspicion of DENV infection. Half of them were returning from Côte d’Ivoire which is a popular tourist and business country for Moroccans and where an outbreak of DENV was confirmed on July 2017. Fever, headache, arthralgia-myalgia and malaise in addition to the notion of return from an endemic country justify in clinicians the demand for analysis of detection of dengue virus by RT-PCR.Dengue infection was confirmed in two patient both coming from Côte d’Ivoire, a Moroccan and an Ivorian who were staying in Abidjan during the period of the outbreak of 2017

Chikungunya infection confirmed in a Moroccan traveller returning from Bangladesh

Recently, several countries reported imported cases of infection with chikungunya virus (CHIKV). We report the first case of chikungunya virus infection in Morocco. A 37-year old woman returned to Morocco on 15 August 2017, after she stayed in Dhaka-Bangladesh for 18months. She developed severe arthralgias and rash, fever up to 39°c. In next day’s symptoms progressively subsided but arthralgias remained for 3weeks. Laboratory findings didn't show lymphopenia, thrombocytopenia or elevated liver transaminases. Serological tests were positive for CHIKV IgM and negative for IgG antibodies. CHIKV-RNA was detected by RT-PCR. The patient was treated with non-steroid anti-inflammatory drugs and paracetamol. After 15days of hospitalization, symptoms ameliorated but arthralgias persists. The vector is established in Morocco and since the virus is diagnosed in returning travellers, chikungunya has a potential for autochthonous transmission in Morocco, that’s why CHIKV must be included in the differential diagnosis of arthralgia in all travellers returning from countries with documented transmission of the virus

HLA-B*44 allele associated with clinical parameters in HIV-1 infected Moroccan cohort

Background: The human leukocyte antigen-B*44 (HLA-B*44) allele has been reported to have promising results in the control of human immunodeficiency virus-1 (HIV-1) infection and associated with protection against HIV-1 disease progression. In the Moroccan HIV-1 infected patients, the contribution of this allele has not been established. This study aimed to evaluate the distribution of HLA-B*44 allele among HIV-1-infected in Morocco. Additionally, investigate HLA-B*44 allele association with demographical and HIV clinical parameters.Methods: One hundred and sixty-seven HIV-1 infected, antiretroviral naive individuals were enrolled in this study. The HLA-B*44 allele screening was performed using the PCR amplification.Results: Of the 167 individuals genotyped, 26 (16%) of them expressing the HLA-B*44 allele. Clinical stages at diagnosis, median pre-treatment HIV viral load (pVL) and CD4 T cell counts differ significantly (p = 0.0001, p=0.001 and p=0.0001 respectively) between the patients who had been expressing the HLA-B*44 allele and patients who had not been expressing this allele. The presence of HLA-B*44 allele was significantly associated with pVL and CD4 T cell counts (p=0.004 and p=0.0001 respectively). The bivariate analysis has showed that the expression of the HLA-B*44 allele was strongly associated with advanced HIV infection (Odd ratio (OR) 0.12 (95% confidence interval (CI) 0.04-0.37), p=0.0001).Conclusions: Author have described for the first time in Morocco the association of the HLA-B*44 allele with the clinical parameters of HIV infection. These results expand the knowledge of the distribution and effect of this allele in the Moroccan population

Recurrence of occult hepatitis B virus infection in a recipient of a liver transplant for HCV-related cirrhosis: full length genome, mutations analysis and literature review

The outcome of liver transplant recipients in HCV chronic carriers with Anti-HBc only concerning occult HBV infection is unknown. We report here the case of a patient who underwent liver transplantation (LT) for cirrhosis post chronic hepatitis C who received an allograft from a donor with no marker of hepatitis B infection. After LT, HBV DNA was detected in the serum in the absence of HBsAg while HCV RNA remained negative. To determine the origin of this occult HBV infection, we retrospectively examined stored serum and liver tissue, pre and post-transplantation, for HBV DNA by PCR. A stored liver biopsy of the donor before transplantation was also tested. HBV DNA was detected in the pre-transplant liver but not in the donor liver. HBV viral load quantified by real time PCR after LT ranged from about 102 to 5x103 HBV DNA copies/mg of liver, while in sera, concentrations ranged from 102 to 3x103 HBV DNA copies/ml. All PCR products in the S gene from liver and sera were sequenced. Analysis of sequences showed the presence of an HBV strain genotype D. The nucleotide homology between the patient’s HBV strains before and after LT was 96 % across the analyzed regions. Full length HBV genomes were amplified from the sera using Rolling Circle Amplification and then sequenced. Analysis of sequences confirmed the genotype D, but did not show obvious mutations that could contribute to HBsAg seronegativity and low HBV viral replication. Factors leading to occult HBV infection are still unclear, but it is well establish that occult HBV infection is frequent in HCV patients. This underlines the role of extra hepatic sites for HBV replication, potentially lymphocytes acting as “reservoirs”.  

The evolving SARS-CoV-2 epidemic in Africa: Insights from rapidly expanding genomic surveillance

INTRODUCTION Investment in Africa over the past year with regard to severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) sequencing has led to a massive increase in the number of sequences, which, to date, exceeds 100,000 sequences generated to track the pandemic on the continent. These sequences have profoundly affected how public health officials in Africa have navigated the COVID-19 pandemic. RATIONALE We demonstrate how the first 100,000 SARS-CoV-2 sequences from Africa have helped monitor the epidemic on the continent, how genomic surveillance expanded over the course of the pandemic, and how we adapted our sequencing methods to deal with an evolving virus. Finally, we also examine how viral lineages have spread across the continent in a phylogeographic framework to gain insights into the underlying temporal and spatial transmission dynamics for several variants of concern (VOCs). RESULTS Our results indicate that the number of countries in Africa that can sequence the virus within their own borders is growing and that this is coupled with a shorter turnaround time from the time of sampling to sequence submission. Ongoing evolution necessitated the continual updating of primer sets, and, as a result, eight primer sets were designed in tandem with viral evolution and used to ensure effective sequencing of the virus. The pandemic unfolded through multiple waves of infection that were each driven by distinct genetic lineages, with B.1-like ancestral strains associated with the first pandemic wave of infections in 2020. Successive waves on the continent were fueled by different VOCs, with Alpha and Beta cocirculating in distinct spatial patterns during the second wave and Delta and Omicron affecting the whole continent during the third and fourth waves, respectively. Phylogeographic reconstruction points toward distinct differences in viral importation and exportation patterns associated with the Alpha, Beta, Delta, and Omicron variants and subvariants, when considering both Africa versus the rest of the world and viral dissemination within the continent. Our epidemiological and phylogenetic inferences therefore underscore the heterogeneous nature of the pandemic on the continent and highlight key insights and challenges, for instance, recognizing the limitations of low testing proportions. We also highlight the early warning capacity that genomic surveillance in Africa has had for the rest of the world with the detection of new lineages and variants, the most recent being the characterization of various Omicron subvariants. CONCLUSION Sustained investment for diagnostics and genomic surveillance in Africa is needed as the virus continues to evolve. This is important not only to help combat SARS-CoV-2 on the continent but also because it can be used as a platform to help address the many emerging and reemerging infectious disease threats in Africa. In particular, capacity building for local sequencing within countries or within the continent should be prioritized because this is generally associated with shorter turnaround times, providing the most benefit to local public health authorities tasked with pandemic response and mitigation and allowing for the fastest reaction to localized outbreaks. These investments are crucial for pandemic preparedness and response and will serve the health of the continent well into the 21st century

Dengue fever in Morocco: result of surveillance during the year 2017 and first imported cases

Dengue is a significant mosquito-borne infection in humans, and its worldwide prevalence is rapidly increasing. The vector aedes albopictus has been revealed recently in the town of Rabat. Morocco established a program of active surveillance of dengue fever comprising many hospitals and laboratories across the kingdom. The purpose of this work is to describe the result of the surveillance of the dengue virus (DENV) infection during the year of 2017 among Moroccans and tourists who presented in our hospital with clinical signs of infection and to report the first confirmed positive cases of Dengue.From 20 December 2016 to 20 December 2017, 21 patients were hospitalized for suspicion of DENV infection. Half of them were returning from Côte d’Ivoire which is a popular tourist and business country for Moroccans and where an outbreak of DENV was confirmed on July 2017. Fever, headache, arthralgia-myalgia and malaise in addition to the notion of return from an endemic country justify in clinicians the demand for analysis of detection of dengue virus by RT-PCR.Dengue infection was confirmed in two patient both coming from Côte d’Ivoire, a Moroccan and an Ivorian who were staying in Abidjan during the period of the outbreak of 2017

Chikungunya infection confirmed in a Moroccan traveller returning from Bangladesh

Recently, several countries reported imported cases of infection with chikungunya virus (CHIKV). We report the first case of chikungunya virus infection in Morocco. A 37-year old woman returned to Morocco on 15 August 2017, after she stayed in Dhaka-Bangladesh for 18months. She developed severe arthralgias and rash, fever up to 39°c. In next day’s symptoms progressively subsided but arthralgias remained for 3weeks. Laboratory findings didn't show lymphopenia, thrombocytopenia or elevated liver transaminases. Serological tests were positive for CHIKV IgM and negative for IgG antibodies. CHIKV-RNA was detected by RT-PCR. The patient was treated with non-steroid anti-inflammatory drugs and paracetamol. After 15days of hospitalization, symptoms ameliorated but arthralgias persists. The vector is established in Morocco and since the virus is diagnosed in returning travellers, chikungunya has a potential for autochthonous transmission in Morocco, that’s why CHIKV must be included in the differential diagnosis of arthralgia in all travellers returning from countries with documented transmission of the virus