title: Human papillomavirus genotypes among women with or without HIV infection: an epidemiological study of Moroccan women from the Souss area.
abstract: BACKGROUND
  Data on Human PapillomaVirus (HPV) infection are scarce in Morocco. The objective of the study was to determine the prevalence of HPV and cervical cytology abnormalities in women from the Souss area, Morocco.
  
  
  METHODS
  Two hundred and thirty two women who attended the Hassan II hospital (Agadir, Morocco) were recruited in this study. Socio-economic data, sexual activity, reproductive life, history of Pap smear, smoking and HIV status were recorded. Cervical samples were taken using an Ayre spatula. Cytology was reported using the Bethesda system. HPVs were first detected by MY09/11 consensus PCR and then genotyped with INNO-LiPA(®) assay. Data were analyzed using the logistic regression model.
  
  
  RESULTS
  The median age of women was 42 years (18-76 years). HIV prevalence was 36.2 %. Any HPV type prevalence was 23.7 % in the study population, lower in HIV-negative women (13.3 %) than in HIV-positive women (39.3 %). HPV16 was the most prevalent type (6.5 %), followed by HPV53 and HPV74 (3.4 % each). Most women had normal cervical smears (82 %), the remaining were diagnosed with LGSIL (13 %) and HGSIL (5 %). HPV was detected in 17.4 % of normal smears, 43.4 % of LGSIL and 75 % of HGSIL. HIV status was the most powerful predictor of high risk (hr) and probable hr (phr) HPV infection (odds ratio 4.16, 95 % confidence interval 1.87-9.24, p = 0.0005) followed by abnormal cytology (OR 3.98, 95 % CI 1.39-11.40, p = 0.01), independently of socio-demographic and behavioral risk factors.
  
  
  CONCLUSIONS
  In a Moroccan hospital based-population of the Souss area, HPV infections are frequently detected. In addition, high prevalence of hr and phrHPVs and precancerous lesions among HIV-positive women is likely associated with an increased risk of cervical cancer. This highlights the need for HPV and cervical cancer prevention campaigns in Morocco.
authors.affiliation: Laboratoire de Biologie Cellulaire et Génétique Moléculaire, Faculté des Sciences, Université Ibn Zohr, BP8106, Agadir, 80000 Maroc ; EA 3181, Lab Ex LipSTIC ANR-11-LABX-0021, Université de Franche-Comté UBFC, F-25000 Besançon, France.
authors.forename: Essaada
authors.initials: E
authors.lastname: Belglaiaa
authors.affiliation: Laboratoire de biologie moléculaire, 5ème Hôpital Militaire, Guelmim, Maroc.
authors.forename: Hicham
authors.initials: H
authors.lastname: Elannaz
authors.affiliation: Service d'anatomopathologie, Hôpital Hassan II, Agadir, Maroc.
authors.forename: Bouchra
authors.initials: B
authors.lastname: Mouaouya
authors.affiliation: Service d'anatomopathologie, Hôpital Hassan II, Agadir, Maroc.
authors.forename: Mohamed
authors.initials: M
authors.lastname: Aksim
authors.affiliation: EA 3181, Lab Ex LipSTIC ANR-11-LABX-0021, Université de Franche-Comté UBFC, F-25000 Besançon, France.
authors.forename: Mariette
authors.initials: M
authors.lastname: Mercier
authors.affiliation: EA 3181, Lab Ex LipSTIC ANR-11-LABX-0021, Université de Franche-Comté UBFC, F-25000 Besançon, France ; Laboratoire de Biologie Cellulaire et Moléculaire, Inserm CIC 1431, CHRU Jean Minjoz, Boulevard Fleming, 25000 Besançon, France.
authors.forename: Jean-Luc
authors.initials: JL
authors.lastname: Prétet
authors.affiliation: Laboratoire de Biologie Cellulaire et Génétique Moléculaire, Faculté des Sciences, Université Ibn Zohr, BP8106, Agadir, 80000 Maroc.
authors.forename: Said
authors.initials: S
authors.lastname: Chouham
authors.affiliation: EA 3181, Lab Ex LipSTIC ANR-11-LABX-0021, Université de Franche-Comté UBFC, F-25000 Besançon, France ; Laboratoire de Biologie Cellulaire et Moléculaire, Inserm CIC 1431, CHRU Jean Minjoz, Boulevard Fleming, 25000 Besançon, France.
authors.forename: Christiane
authors.initials: C
authors.lastname: Mougin
keywords: Cervical cancer; HIV; HPV; Morocco; Pap smear