Hicham Oumzil

HIV-1 infection in children remains a major public health challenge, particularly in resource-limited settings where access to antiretroviral therapy (ART) and routine virological monitoring is limited. The emergence of HIV-1 drug resistance mutations (DRMs) compromises treatment efficacy and threatens long-term therapeutic outcomes. A systematic literature review was conducted using PubMed and Scopus to identify studies published from 2014 onward reporting HIV-1 genotypic resistance profiles in children receiving ART. Eligible studies included original research using Sanger sequencing or next-generation sequencing (NGS). Due to substantial methodological heterogeneity in study design, sequencing approaches, patient populations, and outcome reporting, a meta-analysis was not performed. The review therefore provides a narrative synthesis of resistance patterns and subtype distribution. Included studies involved children aged 2.1–16 years and sample sizes ranging from 3 to 1080 participants. Resistance mutations were most frequently observed in the NNRTI and NRTI classes, particularly K103N and M184V, whereas protease inhibitor and integrase inhibitor resistance remained less common. HIV-1 subtype distribution showed marked geographic variation, with CRF01_AE predominating in Asia, subtype C in Southern Africa, CRF02_AG and CRF06_cpx in West Africa, and subtype B in Europe and the Americas. These findings highlight the substantial burden of pediatric HIV-1 drug resistance and the need for strengthened surveillance and optimized region-specific treatment strategies.

: The 14th African Society of Human Genetics (AfSHG) Morocco Meeting and 2nd International Congress of the Moroccan Society of Genomics and Human Genetics (SM2GH), held in Rabat, Morocco, from December 12 through 17, 2022, brought together 298 attendees from 23 countries, organized by the AfSHG in collaboration with the SM2GH. The conference’s overarching theme was “Applications of Genomics Medicine in Africa,” covering a wide range of topics, including population genetics, genetics of infectious diseases, hereditary disorders, cancer genetics, and translational genetics. The conference aimed to address the lag in the field of genetics in Africa and highlight the potential for genetic research and personalized medicine on the continent. The goal was to improve the health of African populations and global communities while nurturing the careers of young African scientists in the field. Distinguished scientists from around the world shared their recent findings in genetics, immunogenetics, genomics, genome editing, immunotherapy, and ethics genomics. Precongress activities included a 2-day bioinformatics workshop, “NGS Analysis for Monogenic Disease in African Populations,” and a Young Investigators Forum, providing opportunities for young African researchers to showcase their work. The vast genetic diversity of the African continent poses a significant challenge in investigating and characterizing public health issues at the genetic and functional levels. Training, research, and the development of expertise in genetics, immunology, genomics, and bioinformatics are vital for addressing these challenges and advancing genetics in Africa. The AfSHG is committed to leading efforts to enhance genetic research, coordinate training, and foster research collaborations on the continent.

Background. The goal of Acute flaccid paralysis (AFP) surveillance is to comprehensively investigate and report any case of a child below 15 years with a floppy weakness. This is essential for the poliovirus eradication initiative. Objective. In this study, we analyzed the results of nine-year surveillance (20102018) of AFP in Morocco. Method. This was a descriptive, retrospective study of cases with AFP routinely documented at the National Referral Laboratory of Polio (NRLP) from 2010 to 2018. Results. Among the 884 AFP cases identified and analyzed, we identified 11 polioviruses as Sabin-like vaccine strains (PSL). PSL were isolated in 11 samples of AFP cases received at the laboratory, including one PSL1, three PSL2+PSL3, one PSL1+PSL2, and one PSL1+2+3. The annualized nonpolio AFP rate per 100,000 children under 15 years ranged from 0.84 during 20112015 to 2.29 in 2018. The stool adequacy indicator was poor and may be improved with better delivery times and maintaining the cold chain. The incidence of isolated nonpolio enteroviruses (NPEV) varied between 2.27 and 12.6, with the average not exceeding 6.35; the incidence remained low compared to the indicator set by the World Health Organization (WHO). Conclusion. Morocco was certified polio-free by WHO in 2015, and since then no cases of wild poliovirus have been reported. Overall, although the nonpolio AFP rate has risen to the WHO standard, stool adequacy and the proportion of nonpolio enteroviruses need to be improved. The laboratory can adopt alternative techniques, independent of cell culture, to ensure that imported cases of poliovirus are not missed, especially in this era of eradication.

The widespread use of an effective and safe vaccine to measles has substantially decreased morbidity and mortality from this epidemic. Nevertheless, HIV-infected children vaccinated against measles may develop an impaired vaccine response and remain susceptible to this disease. In Morocco, infants are routinely vaccinated against measles, regardless of their HIV serostatus. An evaluation of the immunization of these children may be of paramount importance to implement timely measures aimed at preventing measles transmission. In this study, we have enrolled 114 children vaccinated against measles, 50 children prenatally infected with HIV and 64 HIV-uninfected children. For all children, blood samples were taken to measure anti-measles IgG by EIA and CD4 count by flow cytometry. Additionally, HIV viral load was determined by automated real time PCR, for HIV-infected children. The seroprotective rate of IgG anti-measles antibodies was significantly lower among HIV-infected children (26%) compared with HIV-uninfected children (73%) (p < 0.001). Within HIV-infected children group, the comparison of variables between children without seroprotective seroconversion to measles and those with seroprotective immunity, displayed that sex and age were not statistically different, p > 0.999 and p = 0.730, respectively. However, CD4 count was lower among children with negative serostatus to measles (23% versus 32%, p < 0.001). Furthermore, viral load was higher, with 2.91 log10 ± 2.24 versus 1.7 log10 ± 1.5 (p = 0.042). Finally, 62% of children with a negative vaccine response to measles were under HAART therapy, versus 92% (p = 0.008). The majority of HIV-infected children vaccinated against measles develop a suboptimal seroprotective titer, and therefore remain at risk for this highly infectious disease. These data in combination with international recommendations, including recent WHO guidance on vaccination of HIV-infected children, suggest there is a need for national measures to prevent these children from measles.

Since its development in the early 1980s, Hepatitis B virus (HBV) vaccine has been proven to be highly protective. However, its immunogenicity may be ineffective among HIV-infected children. In Morocco, HBV vaccine was introduced in 1999, and since then all infants, including vertically HIV-infected infants, have been following the vaccination schedule, implemented by the Moroccan ministry of health. An assessment of the immunization of these children is important to optimize efforts aimed at tackling Hepatitis B coinfection, within the country. Forty-nine HIV-infected children (HIV group) and 112 HIV uninfected children (control group) were enrolled in this study. Samples were tested by Elisa (Monolisa Anti-HBs, Biorad) to quantify the anti-HBs antibodies. The % of lymphocyte subsets i.e. CD4+ T cells, CD8+ T cells, B cells, and NK, was determined by flow cytometry, using CellQuest Pro software (Becton-Dickinson), and for HIV group, HIV viral load was measured by real time PCR assay (Abbott). All variables were statistically compared in the two groups. The median age was 51 ± 35 months for the HIV group and 50 ± 36 months (p > 0.05) for the control group. Female represented 63% and 41% (p = 0.01), among the HIV group and the control group, respectively. Among HIV-infected children, 71.4% (35/49) were under HAART therapy at the enrollment in the study. Seroprotection titer i.e. anti-HBs ≥10mUI/ml among control group was 76% (85/112), and only 29% (14/49) among the perinatally HIV-infected children (p < 0.0001). Lower % of CD4 + T cells was observed in HIV-infected children with a poor anti-HBs response. In this studied group, we have shown that despite the vaccination of HIV-children with HBV vaccine, 71% did not show any seroprotective response. These findings support the need for monitoring HBV vaccine response among HIV-infected children in Morocco, in order to revaccinate non-immunized children.

Acute gastroenteritis is a serious cause of child mortality and morbidity in resource-limited countries. A viral etiology is most common, and rotavirus and norovirus are reported to be the leading causative agents. There are still few epidemiological data on the simultaneous occurrence of these viruses in Morocco. The aim of this study was to provide useful epidemiological data on the gastroenteritis associated with rotavirus and norovirus among children aged less than 5 years.