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Resume Introduction Depuis l’avenement de la therapie antiretrovirale et l’allongement de l’esperance de vie des patients, la sante mentale est devenue une preoccupation pour les patients vivant avec le VIH (PvVIH) et pour les soignants. Objectif de notre travail : estimer la prevalence des troubles psychiatriques, etudier la nature de ces troubles et identifier les facteurs de risques sociodemographiques et medicaux influencant la sante mentale des PvVIH. Patients et methodes Etude transversale descriptive menee dans le service des Maladies Infectieuses de janvier 2015 an 2015 portant sur les PvVIH, vus a l’hopital de jour et ayant presente des troubles psychiatriques. Les donnees ont ete recueillies sur les fiches d’exploitation et analysees sur Excel. Resultats La prevalence des troubles est de 3,39 %. La moyenne d’âge est de 39,28 ans (24–58 ans). Le sexe feminin predomine (sex-ratio : 0,62). La plupart des patients sont analphabetes ou ayant un niveau d’etudes primaires (63 %), ont un travail (67 %). Douze patients (17 %) ont un antecedent psychiatrique et 42 patients (61 %) ont presente des troubles au cours du suivi. Les troubles psychiatriques sont domines par la depression (87 %) et l’anxiete (29 %). Les sources presumees des troubles sont la precarite materielle (84 %), le divorce (30 %) et la perte du travail (29 %). Le mode de contamination est essentiellement les rapports heterosexuels (87 %). La duree mediane d’infection VIH est de trois ans (un mois-18 ans). La majorite des patients (77 %) sont sous therapie antiretrovirale dont 64 % ont un taux des lymphocytes CD4 Conclusion Les manifestations psychiatriques sont frequentes au cours de l’infection a VIH. Elles sont dominees par la depression et sont responsables de l’echec therapeutique, d’ou la necessite de la collaboration entre psychiatre et infectiologue dans la prise en charge des PvVIH.

Background In Morocco, of the estimated 29,000 people living with HIV in 2011, only 20% were aware of their HIV status. More than half of diagnoses were at the AIDS stage. We assumed that people who were unaware of their infection had contacts with the healthcare system for HIV indicators that might prompt the healthcare provider to offer a test. The aim was to assess missed opportunities for HIV testing in patients newly diagnosed with HIV who accessed care in Morocco. Methods A cross-sectional study was conducted in 2012–2013 in six Moroccan HIV centers. Participants were aged ≥18, and had sought care within 6 months after their HIV diagnosis. A standardized questionnaire administered during a face-to-face interview collected the patient’s characteristics at HIV diagnosis, HIV testing and medical history. Contacts with care and the occurrence of clinical conditions were assessed during the 3 years prior to HIV diagnosis. Over this period, we assessed whether healthcare providers had offered HIV testing to patients with HIV-related clinical or behavioral conditions. Results We enrolled 650 newly HIV-diagnosed patients (median age: 35, women: 55%, heterosexuals: 81%, diagnosed with AIDS or CD4 3: 63%). During the 3 years prior to the HIV diagnosis, 71% (n = 463) of participants had ≥1 contact with the healthcare system. Of 323 people with HIV-related clinical conditions, 22% did not seek care for them and 9% sought care and were offered an HIV test by a healthcare provider. The remaining 69% were not offered a test and were considered as missed opportunities for HIV testing. Of men who have sex with men, 83% did not address their sexual behavior with their healthcare provider, 11% were not offered HIV testing, while 6% were offered HIV testing after reporting their sexual behavior to their provider. Conclusions Among people who actually sought care during the period of probable infection, many opportunities for HIV testing, based on at-risk behaviors or clinical signs, were missed. This highlights the need to improve the recognition of HIV clinical indicators by physicians, further expand community-based HIV testing by lay providers, and implement self-testing to increase accessibility and privacy.

Additional file 1: Fig. S1. Distribution of HIV/AIDS cases in Morocco by region, 2005–2009.

Additional file 2: Fig. S2. Characteristics of patients who sought care for a clinical indicator in the three years prior to HIV diagnosis according to whether or not (missed opportunity) the care provider offered them an HIV test (n = 252).

Human Immunodeficiency Virus type 1 (HIV-1) infection and progression varies widely among individuals. Interferon-λ3 exerts anti-HIV function by activating JAK/STAT pathway-mediated innate immunity. Therefore, we aimed to investigate the association between single nucleotide polymorphisms of the interleukin 28B (IL28B) gene, and the risk of acquisition, AIDS development and therapeutic outcome of HIV-1 in a Moroccan population. A total of 266 HIV-1 seropositive and 158 HIV-1 seronegative subjects were enrolled. Genotyping of rs12979860 of the IL28B was performed using a predesigned TaqMan SNP genotyping assay. No significant association was found between IL28B rs12979860 polymorphism and susceptibility to HIV-1 infection and AIDS development (p > .05). However, in HIV-1 treated patients carrying CC genotype had a more pronounced high levels of CD4 + T-cell compared to subjects with TT genotype (p = .0004). Interestingly, regarding HIV-1 viral load no significant differences between IL28B genotypes in treated and untreated patients were observed (p IL28B rs12979860 polymorphism not influences the susceptibility to HIV-1 and the AIDS development. However, this polymorphism may affect the response to treatment as measured by CD4+ T cell counts.

Background Human papillomavirus (HPV) is the most common sexually transmitted agent worldwide. HPV is the main causative agent for cervical cancer. The HPV oncoprotein E6 binds to the tumor suppressor gene product p53, promoting its degradation; the Arg allele of TP53 R72P polymorphism binds more ardently with HPV E6 than the Pro variant. Here, we investigated whether TP53 R72P gene variant, rs104252, was associated with susceptibility to HPV infection in women with human immunodeficiency virus (HIV). Methods We analyzed 200 HPV-positive and 68 uninfected women with HIV. Genomic DNA was isolated from cervical swab. The TP53 R72P polymorphism was genotyped by PCR-RFLP. Unconditional logistic regression was used to assess the association between polymorphism and the clinical, lifestyle, and behavioral data. Results The genotype and allele frequencies of rs104252 variant did not differ between women without or with HPV infection (P > 0.05). Moreover, the p53 polymorphism was not associated with cervical cytology. In contrast, when we analyzed according to behavior factors, the P72P genotype was more frequent among HPV-positive smoker women. However, no significant relationship was found between alcohol, contraceptive use, and number of partners with TP53 R72P genotype distributions among HPV-positive cases (P > 0.05). Conclusions The R72 variant of p53 R72P is not associated with HPV infection and progression of lesions. There was no association between this variant and behavior factors in HPV-positive cases. The P72P genotype may be more frequent among HPV-positive smoker women.

La Presse Medicale - In Press.Proof corrected by the author Available online since jeudi 12 decembre 2013

Summary Objective To describe the causes of death occurring during the antiretroviral therapy in Casablanca. Methods Retrospective study of a cohort of HIV positive patients attending the infectious diseases unit of Casablanca receiving antiretroviral therapy. Files of 91patients who died were analyzed. Results Since June 1999, 1243 patients were treated and 91 deaths occurred (7, 3%). The mean age at time of death was 36 years. Forty-six patients were male (50, 5%) and 86 were stage C (94, 5%). At the initiation of treatment, mean CD4 count was 96 cells/mL (1–626) and mean plasma HIV- RNA was 5, 65 log10. They have received antiretroviral therapy for a mean of 9 months (1–48 months). At time of death, 37 patients (52, 8%) had a CD4 count greater than 200 cells/mL and 16 patients (23%) had undetectable plasma viral load. In 57 cases (63%), the death occurred within the first year after start of antiretroviral therapy. The main causes of death were: tuberculosis (35%), cryptosporidiosis (19%), cryptococcosis (13%), cerebral toxoplasmosis (9%), Kaposi sarcoma (6%), non Hodgkin's lymphoma (2%), atypical mycobacteriosis (2%), cerebral lymphoma (1%), aspergillosis (1%), HIV wasting syndrome (1%) and cancer of cervix (1%). Non AIDS related deaths were noticed in three cases (3%) and the immune reconstitution inflammatory syndrome in six cases (7%). Conclusion In Casablanca, the main cause of death among HIV-infected patients is tuberculosis. Collaboration between the national tuberculosis and AIDS programs has been established to improve the prevention, detection, diagnosis and management of HIV/tuberculosis co infection.

To describe the causes of death occurring during the antiretroviral therapy in Casablanca.Retrospective study of a cohort of HIV positive patients attending the infectious diseases unit of Casablanca receiving antiretroviral therapy. Files of 91 patients who died were analyzed.Since June 1999, 1243 patients were treated and 91 deaths occurred (7, 3%). The mean age at time of death was 36 years. Forty-six patients were male (50, 5%) and 86 were stage C (94, 5%). At the initiation of treatment, mean CD4 count was 96 cells/mL (1-626) and mean plasma HIV- RNA was 5, 65 log10. They have received antiretroviral therapy for a mean of 9 months (1-48 months). At time of death, 37 patients (52, 8%) had a CD4 count greater than 200 cells/mL and 16 patients (23%) had undetectable plasma viral load. In 57 cases (63%), the death occurred within the first year after start of antiretroviral therapy. The main causes of death were: tuberculosis (35%), cryptosporidiosis (19%), cryptococcosis (13%), cerebral toxoplasmosis (9%), Kaposi sarcoma (6%), non Hodgkin's lymphoma (2%), atypical mycobacteriosis (2%), cerebral lymphoma (1%), aspergillosis (1%), HIV wasting syndrome (1%) and cancer of cervix (1%). Non AIDS related deaths were noticed in three cases (3%) and the immune reconstitution inflammatory syndrome in six cases (7%).In Casablanca, the main cause of death among HIV-infected patients is tuberculosis. Collaboration between the national tuberculosis and AIDS programs has been established to improve the prevention, detection, diagnosis and management of HIV/tuberculosis co infection.