Hepatitis C viral load and genotypes distribution among chronically infected patients in Morocco

Purpose: In Morocco, the hepatitis C virus (HCV) genotypic distribution is poorly studied and not continuously updated. The aim of this study is to characterize HCV genotypes diversity and dynamics in Morocco. Methods: A retrospective study carried out between 2003 and 2020 on 2101 patients HCV-positive at the mo-lecular biology laboratory of Pasteur Institute of Morocco (IPM), involving HCV quantification through real-time PCR (RT-PCR) and HCV genotyping through reverse hybridization. All the 2101 patients had a viral load higher than 15 IU/mL. Alanine transaminase (ALT) levels and Fibrotest were performed in 150 patients. Results: The 2101 analyzed patients had a mean age of 59.52 +/- 12.98 years. The average viral load was 5.23 +/- 0.82 log IU/mL, and females were more affected than males (sex-ratio = 0.75, p < 0.05). Genotypes 1 (54.18 %) and 2 (42.98 %) were the most prevalent, while genotypes 3, 4 and 5 were rarely found. HCV subtypes were distributed as follows: 1b (37.74 %), 2a/2c (28.18 %), 2 UC (14.80 %), 1 UC (9.47 %), 1a (5.14 %), 1a/1b (2.43 %), 4 UC (0.90 %), 3 UC (0.57 %), 3a (0.48 %), 4a (0.14 %), 5 UC (0.10 %), and 5a (0.05 %). Genotype 3 was detected for the first time in our country in 2013 and increased over time. Advanced liver fibrosis was associated with genotype 1b followed by genotype 2a/2c, with genotype 1b demonstrates a propensity for heightened virulence (p < 0.05) in the present study. Conclusion: Our study reports the most recent data on HCV genotypes distribution in Morocco and the importance of analyzing HCV variability as it offers insights into the virus's dynamics in the population, enabling the monitoring of new migratory flows and their influence on the transition's rate to chronic infection.