International Journal of Clinical Science and Medical Research

Background: In Morocco, the transition from Western Blot (WB) to viral load testing for HIV confirmation aligns with WHO recommendations. This study evaluates the diagnostic performance of PCR-based viral load as an alternative to WB in a Moroccan clinical context.

Methods: A retrospective descriptive analysis was conducted using data from 232 hospitalized patients (175 men, 94 women; median age 42–44 years) at Ibn Rochd University Hospital (April 2021–March 2022). WB and initial pre-therapeutic viral load (quantitative RT-PCR) results were compared. Statistical measures included sensitivity, specificity, positive predictive value (PPV), and Youden Index (YI).

Results: Viral load testing demonstrated 95% sensitivity, 100% specificity, and 100% PPV, with a YI of 95%. Notably, 52.8% of patients exhibited high or very high viral loads (>100,000 copies/mL), reflecting delayed diagnosis. WB, while specific (99.9%), has limitations in turnaround time and early-phase sensitivity.

Conclusion: PCR-based viral load testing offers superior advantages, including rapid results, quantitative assessment, and enhanced sensitivity during early infection. Its high diagnostic accuracy supports its adoption as a confirmatory tool in Morocco, aligning with national goals to improve early HIV diagnosis, patient management, and epidemic control. Study limitations include retrospective design and potential hospital-based selection bias. These findings advocate for policy shifts toward molecular testing to optimize HIV care in resource-limited settings.

HIV, PCR, Western blott, Viral Load

1. UNAIDS. 2022 Fact Sheet – Global HIV Statistics, https://www.unaids.org/en/resources/fact-sheet, accessed on 22/03/2025.
2. Kingdom of Morocco, Ministry of Health and National Human Rights Council. National Strategy on Human Rights and HIV, Tuberculosis and Viral Hepatitis. https://www.sante.gov.ma/Documents/2023/11/strat%C3%A9gie%20DH%202024-2030.pdf, accessed on 22/03/2025.
3. World Health Organization. WHO recommends countries to stop using Western Blots and strip-based immunoassays in HIV testing strategies and algorithms.https://www.afro.who.int/sites/default/files/2020-03/L%27OMS%20recommande%20au%20pays%20de%20cesser%20d%27utiliser%20les%20western%20blots%20et%20les%20immumosages%20sur%20bandelettes%20dans%20les%20strat%C3%A9gies%20et%20les%20algorithmes%20de%20d%C3%A9pistage%20du%20VIH.pdf, accessed on 22/03/2025.
4. Moroccan Ministry of Health. National HIV Testing Strategy 2021–2026. https://www.sante.gov.ma/Documents/2023/11/strat%C3%A9gie%20d%C3%A9pistage%202021-2026.pdf, accessed on 22/03/2025.
5. Branson, Bernard M., Owen, S. Michele, Wesolowski, Laura G., et al. Laboratory testing for the diagnosis of HIV infection: updated recommendations, 2014.
6. Fiebig, Eberhard W., Wright, David J., Rawal, Bhupat D., et al. Dynamics of HIV viremia and antibody seroconversion in plasma donors: implications for diagnosis and staging of primary HIV infection. AIDS, 2003, vol. 17, no. 13, pp. 1871–1879.