Mohamed Rida Tagajdid, Sanae Azelmat, Hamza Goura, Mohamed Rida Znady, Diyae Mansouri, Rachid Abi, Hicham Elannaz, Safae Elkochri, Abdelilah Laraqui, Larbi Bouaiti, Fatima Elmengoub, Mohamed Ait Bouhou, Khalid Ennibi, Jaouad Kouach, Idriss Amine Lahlou
This study provides the first detailed characterization of HR-HPV prevalence and genotype distribution in Moroccan women attending a tertiary hospital. HPV16 remains the predominant genotype. A significant proportion of infections are preventable by the 9-valent vaccine. These findings highlight the urgent need for expanded HPV vaccination and molecular-based screening programs in Morocco and provide a critical baseline for monitoring vaccine impact and guiding public health strategies.
BACKGROUND: Cervical cancer (CC) remains a major public health challenge in Morocco, where it is the second most frequent cancer among women. Persistent infection with high-risk human papillomavirus (HR-HPV) is the primary etiological factor. Limited data exist regarding HPV genotype distribution and associated risk factors in the Moroccan female population.
METHODS: A retrospective, descriptive, and analytical study was conducted at the Mohammed V Military Teaching Hospital, Rabat, Morocco, between May 2023 and April 2025. Asymptomatic women aged 30-65 years undergoing routine CC screening were included. Cervical samples were collected using liquid-based cytology medium and analyzed for HR-HPV using the Cobas® 4800 assay. Samples positive for pooled HR-HPV (excluding HPV16/18) underwent extended genotyping using the HPV002® assay. Sociodemographic, behavioral, and clinical data were collected via standardized questionnaires. Statistical analysis included prevalence estimates, univariate, and multivariate logistic regression to identify factors independently associated with HR-HPV infection.
RESULTS: Of 2.235 eligible women, HR-HPV prevalence was 5.5% (n=123). HPV16 was the most prevalent genotype (19.5%), followed by HPV68 (12.2%), HPV31 (9.8%), HPV33 (7.3%), HPV35 (7.3%), and HPV39 (7.3%). Single-genotype infections predominated (95%), with dual infections in 5% of cases. Genotypes targeted by the 9-valent HPV vaccine accounted for 58.5% of infections. Multivariate analysis identified diabetes/immunosuppression, hormonal contraceptive use, and inflammatory cervical abnormalities as independent predictors of HR-HPV infection. 75% of HR-HPV-positive women were over 40 years, with a peak prevalence in the 50-59 age group.
CONCLUSION: This study provides the first detailed characterization of HR-HPV prevalence and genotype distribution in Moroccan women attending a tertiary hospital. HPV16 remains the predominant genotype. A significant proportion of infections are preventable by the 9-valent vaccine. These findings highlight the urgent need for expanded HPV vaccination and molecular-based screening programs in Morocco and provide a critical baseline for monitoring vaccine impact and guiding public health strategies.