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.  

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”.  

Occult hepatitis B virus infection in Moroccan HIV infected patients

Background: The purpose of this study is to assess the prevalence of Occult hepatitis B virus Infection (OBI) among antiretroviral treatment naïve HIV-1 infected individuals in Morocco and to determine factors favouring its occurrence.Methods: The retrospective study was conducted in the Mohammed V military teaching hospital in Rabat between January 2010 and June 2011. It included patients with confirmed HIV infection, tested negative to serological detection of HBV surface antigen (HBsAg) and did not received antiviral treatment or hepatitis B vaccine. All samples were tested for anti-HBc, anti-HBs and anti-HCV antibodies using enzyme immunoassay (ELISA). The detection of HBV DNA was performed by real-time PCR using two specific primers for a gene in the region C of the viral genome. The sensitivity of the technique was 20 copies/ml.Results: A total of 82 samples were analyzed, 19 (23 %) were found to have isolated anti-HBc, 07 (8.5%) with associated anti-HBc and Anti-HBs. No anti-HCV marker was detected on these screening samples. The HBV DNA was detected in 48 (58%) samples, of which, males constituted 58% (28/48). The mean age of these patients was 38 ± 8.2 (29-56), the median HIV-1 viral load and CD4 cell count HIV-1 infected patients were 127500 (54108-325325) copies/ml and 243 [80-385] cells/mm3 respectively and 27.1% (13/48) of these patients were found to have isolated anti-HBc. A significant correlations between DNA HBV and HIV viral load higher than 100000 copies/ml (P = 0.004), CD4 cell count lower than 400 cells/mm3 (P = 0.013, P = 0.006) and isolated anti-HBc samples (P <0.005) were founded. However there was no significant association with age, sex, transmission mode and clinical stage.  Conclusion: The consequences of this high prevalence of OBI in Morocco need to be considered in laboratory diagnosis of HBV infection in HIV infected patients and the PCR seems to be inevitable for a better diagnosis and therapy.

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

Investment in severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) sequencing in Africa over the past year has led to a major increase in the number of sequences that have been generated and used to track the pandemic on the continent, a number that now exceeds 100,000 genomes. Our results show an increase in the number of African countries that are able to sequence domestically and highlight that local sequencing enables faster turnaround times and more-regular routine surveillance. Despite limitations of low testing proportions, findings from this genomic surveillance study underscore the heterogeneous nature of the pandemic and illuminate the distinct dispersal dynamics of variants of concern-particularly Alpha, Beta, Delta, and Omicron-on the continent. Sustained investment for diagnostics and genomic surveillance in Africa is needed as the virus continues to evolve while the continent faces many emerging and reemerging infectious disease threats. These investments are crucial for pandemic preparedness and response and will serve the health of the continent well into the 21st century

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

EVALUATION OF THREE COVID-19 ANTIGEN ASSAY VERSUS PCR DETECTION IN ROUTINE PRACTICE

According to WHO, molecular testing is the "Gold Standard" for the diagnosis of SARS-CoV-2 infection. However, these tests have some limitations in practice (well trained staff, specific equipment requirements, organization of area and time frame for reporting results). Thus, rapid antigen test (RAT) for the detection of one or several SARS-CoV-2 antigens have emerged. We evaluated the analytical performance of 3 RAT used in our laboratory : FREND® Ag COVID-19 (NanoEntek) (FA), STANDARD Q COVID-19 Ag (SD Biosensor) (BA), PANBIO™ COVID-19 Ag RAPID TEST DEVICE (Abbott) (PA) in comparaison to rRT-PCR results. Our study indicates that PA and SA antigen tests have a very good sensitivity to identify infected patients with COVID-19 specifically between in the 0-5 days time-window post onset of symptoms. Nevertheless, one out of three antigen tests (FA) showed very poor clinical performance.</jats:p

Epidemiological, Clinical and Virological Characteristics of Patients with Hepatitis C in Morocco

Objectives: In Morocco, the exact and recent prevalence of Hepatitis C Virus (HCV) infection is not well-known, due to the lack of recent epidemiological studies of the general Moroccan population. The objective of this study was to determine the prevalence of HCV and to describe the epidemiological, clinical and virological characteristics of patients infected with HCV diagnosed at the Mohammed V Military Teaching Hospital in Rabat, Morocco.&#x0D; Methods: This was a prospective study, spread over a period of 3 years (April 2015 - April 2018). All patients with a positive anti-HCV serology were included in the study except those on hemodialysis. In addition to HCV serology, all patients included benefited from HIV serology as well as the Hbs antigen by a Chemiluminescent type Microparticle Immuno-Assay technique (Architect®, Abbott). RNA viral load and HCV genotyping was carried out using a real-time polymerase chain reaction.&#x0D; Results: We collected 14,944 samples, of which 269 had positive anti-HCV antibodies (1.8%). The average age of patients with positive HCV serology was 61 years, the sex ratio (Male/Female) was 1.4. Dental care was identified in 53% of the cases. Viral hepatitis C was identified in 82% of cases during a systematic check up. The main clinical signs reported in our series were asthenia (25% of cases) and subicterus (7% of cases).&#x0D; Conclusion and Implications for Translation: In Morocco, the exact prevalence of HCV infection is not well known, due to the lack of recent epidemiological studies of the general Moroccan population. Our study showed a prevalence of about 1.8% which is in accordance with the World Health Organization (WHO) estimation of between 1% and 2.49%.Our Epidemiological study provides important on the extent of the problem in Morocco, it raises the interest of mass screening and describes the populations at risk that will need to be identified as a priority.&#x0D; Key words: • Epidemiology • Diagnosis • Hepatitis C • Morocco • Risk factor • Military Hospital • Virology&#x0D;  &#x0D; Copyright © 2020 Tagajdid et al. This is an open-access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.</jats:p