HUMAN PAPILLOMAVIRUS GENOTYPE DISTRIBUTION AMONG ADULT WOMEN IN THE RABAT REGION (MOROCCO): A RETROSPECTIVE AND...

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.

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.

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.

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.