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ORIGINAL RESEARCH ARTICLE

Viral suppression and immune recovery after antiretroviral therapy initiation in a Moroccan human immunodeficiency virus type 1-infected cohort: A retrospective analysis

Maryam Ahmina1,2 ,  Nada Lamrak1,2 ,  Ahmed Reggad1,3 ,  Mohamed Rida Tagajdid1,2,3 ,  Rachid Abi1,2,3 ,  Mohamed Elqatni1,2,3 ,  Abdelilah Laraqi1,3 ,  Safae Elkochri3 ,  Elarbi Bouaiti2,3 ,  Youssef Addi3 ,  Bouchra El Mchichi1,3 ,  Nadia Touil1,3 ,  Hicham El Annaz1,2,3* ,  Ennibi Khalid1,2,3 ,  Idriss Amine Lahlou1,2,3
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1 Molecular Virology and Oncobiology Research Team, Faculty of Medicine and Pharmacy, University Mohammed V, Rabat, Morocco
2 Faculty of Medicine and Pharmacy, University Mohammed V, Rabat, Morocco
3 Center of Virology, Infectious, and Tropical Diseases, Mohamed V Military Instruction Hospital, Rabat, Morocco
EJMO, 025370388 https://doi.org/10.36922/EJMO025370388
Received: 10 September 2025 | Revised: 9 December 2025 | Accepted: 12 December 2025 | Published online: 28 May 2026
© 2026 by the Author(s). This article is an open access article distributed under the terms and conditions of the Creative Commons Attribution -Noncommercial 4.0 International License (CC-by the license) ( https://creativecommons.org/licenses/by-nc/4.0/ )
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Abstract

Introduction: Morocco has made substantial progress in expanding human immunodeficiency virus (HIV) testing and treatment, yet longitudinal data on immuno-virologic outcomes remain limited.

Objective: We sought to define the clinical profile at presentation and analyze long-term immuno-virologic outcomes under expanding integrase inhibitor-based treatment.

Methods: We performed a retrospective analysis of patients with confirmed HIV-1 infection who initiated antiretroviral therapy at the Center of Virology, Infectious, and Tropical Diseases at the Military Training Hospital between 2017 and 2025. Demographic, clinical, immunological, and virological data were collected at baseline and throughout follow-up. Statistical analyses were conducted using the Statistical Package for Social Sciences software.

Results: Late presentation was common: 35.7% presented with Centers for Disease Control and Prevention stage C, and 41.5% had CD4 < 200 cells/μL. Women had higher baseline cluster of differentiation 4 (CD4) counts than men (416 vs. 250 cells/μL; p = 0.001), whereas men displayed higher viral loads (1.19 × 105 vs. 5.51 × 104 copies/mL; p = 0.005). Opportunistic infections remained substantial, including cytomegalovirus (16.5%), tuberculosis (12.5%), and toxoplasmosis (5.8%). First-line therapy was initially non-nucleoside reverse transcriptase inhibitor-based in half of the patients, but rapid national adoption of updated guidelines led to 93.8% receiving dolutegravir plus two nucleoside reverse transcriptase inhibitors at the last follow-up. Viral loads declined sharply within the first month, with most patients achieving and maintaining suppression from months 6–12 onward. CD4 counts rose from a median of 279 cells/μL at baseline to 560 at year 3, peaking at 610 at year 5 before stabilizing.

Conclusion: Morocco’s transition to dolutegravir-based antiretroviral therapy has produced durable virologic control and robust immune recovery. Persistent late diagnosis, sex-based disparities, and limited access to genotyping remain major obstacles. Strengthening early testing, expanding molecular monitoring, and enhancing differentiated care services will be essential to sustain national progress.

Keywords
Human immunodeficiency virus type 1
Epidemiology
Immuno-virologic surveillance
Clinical characteristics
Antiretroviral therapy
Morocco
Funding
None.
Conflict of interest
The authors declare that there is no conflict of interest.
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Eurasian Journal of Medicine and Oncology, Electronic ISSN: 2587-196X Print ISSN: 2587-2400, Published by AccScience Publishing
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