Genotypic Analysis of Transmitted and Acquired HIV Drug Resistance in People Living with HIV/AIDS in Surabaya, Indonesia, from 2018 to 2019

Background: Despite the availability of various effective antiretroviral (ARV) drugs, human immunodeficiency virus (HIV) infection has come with HIV drug resistance (HIVDR), which compromises its effectiveness in reducing HIV-related morbidity, mortality, and transmission. The emergence of transmit...

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Main Authors: Brian Eka Rachman, Ni Luh Ayu Megasari, Siti Qamariyah Khairunisa, Tomohiro Kotaki, M Vitanata Arfijanto, Usman Hadi, Nasronudin Nasronudin, Masanori Kameoka
Format: Article
Language:English
Published: Interna Publishing 2024-07-01
Series:Acta Medica Indonesiana
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Online Access:http://www.actamedindones.org/index.php/ijim/article/view/2551
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author Brian Eka Rachman
Ni Luh Ayu Megasari
Siti Qamariyah Khairunisa
Tomohiro Kotaki
M Vitanata Arfijanto
Usman Hadi
Nasronudin Nasronudin
Masanori Kameoka
author_facet Brian Eka Rachman
Ni Luh Ayu Megasari
Siti Qamariyah Khairunisa
Tomohiro Kotaki
M Vitanata Arfijanto
Usman Hadi
Nasronudin Nasronudin
Masanori Kameoka
author_sort Brian Eka Rachman
collection DOAJ
description Background: Despite the availability of various effective antiretroviral (ARV) drugs, human immunodeficiency virus (HIV) infection has come with HIV drug resistance (HIVDR), which compromises its effectiveness in reducing HIV-related morbidity, mortality, and transmission. The emergence of transmitted (TDR) and acquired HIVDR (ADR) among antiretroviral therapy (ART)-naïve and experienced individuals have been reported in several Indonesian regions. Therefore, continuous HIVDR surveillance is needed in Indonesia, especially in Surabaya, which is identified as having the highest prevalence of HIV infection in East Java; thus, this study aimed to identify the emergence of TDR and ADR among people living with HIV/acquired immune deficiency syndrome (AIDS) (PLWHA). Methods: Fifty-eight PLWHA infected with HIV type 1 (HIV-1), comprising 21 and 37 ART-naïve and experienced individuals were enrolled in this study, respectively. Blood samples collected from study participants were subjected to genotypic analysis, mainly towards the pol gene encoding protease (PR gene) and reverse transcriptase (RT gene) of HIV-1. Results: Seventeen PR and 21 RT genes were successfully amplified and sequenced from 29 samples. HIV-1 subtyping revealed CRF01_AE as the most dominant subtype (24/29; 82.76%), followed by subtype B (3/29; 10.34%). Uncommon subtypes, including subtype D and a recombinant containing subtypes B and G genomic fragments, were also identified. TDR for PR inhibitors was not detected; however, TDR and ADR for RT inhibitors were identified in 11.11% and 41.67% of samples, respectively. Two amino acid insertions at position 69 of the RT gene (69ins), a previously never-reported mutation in Indonesia, were identified in this study. Conclusion: Both TDR and ADR have emerged among PLWHA residing in Surabaya, East Java, Indonesia. Uncommon drug-resistance mutations and subtypes were identified in this study. These situations might hamper ART efficacy and treatment success. Continuous surveillance of HIVDR is necessary to monitor both TDR and ADR in Indonesia.
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spelling doaj-art-2f38f326fbac44d9abe322e95968efb02025-08-20T03:50:00ZengInterna PublishingActa Medica Indonesiana0125-93262338-27322024-07-01562Genotypic Analysis of Transmitted and Acquired HIV Drug Resistance in People Living with HIV/AIDS in Surabaya, Indonesia, from 2018 to 2019Brian Eka Rachman0Ni Luh Ayu Megasari1Siti Qamariyah Khairunisa2Tomohiro Kotaki3M Vitanata Arfijanto4Usman Hadi5Nasronudin Nasronudin6Masanori Kameoka71. Internal Medicine Subspecialist Program, Faculty of Medicine, Universitas Airlangga, Surabaya, Indonesia. 2. Universitas Airlangga Hospital, Universitas Airlangga, Surabaya, Indonesia.1. Postgraduate School, Universitas Airlangga, Surabaya, Indonesia. 2. Indonesian-Japan Collaborative Research Center for Emerging and Re-Emerging Infectious Diseases, Institute of Tropical Disease, Universitas Airlangga, Surabaya, Indonesia.1. Indonesian-Japan Collaborative Research Center for Emerging and Re-Emerging Infectious Diseases, Institute of Tropical Disease, Universitas Airlangga, Surabaya, Indonesia. 2. Student of Doctoral Program, Faculty of Medicine, Universitas Airlangga, Surabaya, Indonesia.Department of Virology, Research Institute for Microbial Diseases, Osaka University, Osaka, JapanDivision of Tropical and Infectious Diseases, Department of Internal Medicine, Faculty of Medicine, Universitas Airlangga, Surabaya, IndonesiaDivision of Tropical and Infectious Diseases, Department of Internal Medicine, Faculty of Medicine, Universitas Airlangga, Surabaya, Indonesia1. Universitas Airlangga Hospital, Universitas Airlangga, Surabaya, Indonesia. 2. Division of Tropical and Infectious Diseases, Department of Internal Medicine, Faculty of Medicine, Universitas Airlangga, Surabaya, Indonesia.1. Indonesian-Japan Collaborative Research Center for Emerging and Re-Emerging Infectious Diseases, Institute of Tropical Disease, Universitas Airlangga, Surabaya, Indonesia. 2. Center for Infectious Diseases, Kobe University Graduate School of Medicine, Kobe, Japan. 3. Division of Global Infectious Diseases, Department of Public Health, Kobe University Graduate School of Health Sciences, Kobe, Japan. Background: Despite the availability of various effective antiretroviral (ARV) drugs, human immunodeficiency virus (HIV) infection has come with HIV drug resistance (HIVDR), which compromises its effectiveness in reducing HIV-related morbidity, mortality, and transmission. The emergence of transmitted (TDR) and acquired HIVDR (ADR) among antiretroviral therapy (ART)-naïve and experienced individuals have been reported in several Indonesian regions. Therefore, continuous HIVDR surveillance is needed in Indonesia, especially in Surabaya, which is identified as having the highest prevalence of HIV infection in East Java; thus, this study aimed to identify the emergence of TDR and ADR among people living with HIV/acquired immune deficiency syndrome (AIDS) (PLWHA). Methods: Fifty-eight PLWHA infected with HIV type 1 (HIV-1), comprising 21 and 37 ART-naïve and experienced individuals were enrolled in this study, respectively. Blood samples collected from study participants were subjected to genotypic analysis, mainly towards the pol gene encoding protease (PR gene) and reverse transcriptase (RT gene) of HIV-1. Results: Seventeen PR and 21 RT genes were successfully amplified and sequenced from 29 samples. HIV-1 subtyping revealed CRF01_AE as the most dominant subtype (24/29; 82.76%), followed by subtype B (3/29; 10.34%). Uncommon subtypes, including subtype D and a recombinant containing subtypes B and G genomic fragments, were also identified. TDR for PR inhibitors was not detected; however, TDR and ADR for RT inhibitors were identified in 11.11% and 41.67% of samples, respectively. Two amino acid insertions at position 69 of the RT gene (69ins), a previously never-reported mutation in Indonesia, were identified in this study. Conclusion: Both TDR and ADR have emerged among PLWHA residing in Surabaya, East Java, Indonesia. Uncommon drug-resistance mutations and subtypes were identified in this study. These situations might hamper ART efficacy and treatment success. Continuous surveillance of HIVDR is necessary to monitor both TDR and ADR in Indonesia. http://www.actamedindones.org/index.php/ijim/article/view/2551HIV-1Surabayaantiretroviral therapy (ART)transmitted HIV drug resistance (TDR)acquired HIV drug resistance (ADR)
spellingShingle Brian Eka Rachman
Ni Luh Ayu Megasari
Siti Qamariyah Khairunisa
Tomohiro Kotaki
M Vitanata Arfijanto
Usman Hadi
Nasronudin Nasronudin
Masanori Kameoka
Genotypic Analysis of Transmitted and Acquired HIV Drug Resistance in People Living with HIV/AIDS in Surabaya, Indonesia, from 2018 to 2019
Acta Medica Indonesiana
HIV-1
Surabaya
antiretroviral therapy (ART)
transmitted HIV drug resistance (TDR)
acquired HIV drug resistance (ADR)
title Genotypic Analysis of Transmitted and Acquired HIV Drug Resistance in People Living with HIV/AIDS in Surabaya, Indonesia, from 2018 to 2019
title_full Genotypic Analysis of Transmitted and Acquired HIV Drug Resistance in People Living with HIV/AIDS in Surabaya, Indonesia, from 2018 to 2019
title_fullStr Genotypic Analysis of Transmitted and Acquired HIV Drug Resistance in People Living with HIV/AIDS in Surabaya, Indonesia, from 2018 to 2019
title_full_unstemmed Genotypic Analysis of Transmitted and Acquired HIV Drug Resistance in People Living with HIV/AIDS in Surabaya, Indonesia, from 2018 to 2019
title_short Genotypic Analysis of Transmitted and Acquired HIV Drug Resistance in People Living with HIV/AIDS in Surabaya, Indonesia, from 2018 to 2019
title_sort genotypic analysis of transmitted and acquired hiv drug resistance in people living with hiv aids in surabaya indonesia from 2018 to 2019
topic HIV-1
Surabaya
antiretroviral therapy (ART)
transmitted HIV drug resistance (TDR)
acquired HIV drug resistance (ADR)
url http://www.actamedindones.org/index.php/ijim/article/view/2551
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