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

Rachman, Brian Eka; Megasari, Ni Luh Ayu; Khairunisa, Siti Qamariyah; Kotaki, Tomohiro; Arfijanto, M Vitanata; Hadi, Usman; Nasronudin, Nasronudin; Kameoka, Masanori

Jurnal SINTA 1

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 · Vol. 56 No. 2 (2024)

ISSN: 2338-2732, 0125-9326
Terbit: 2024-07-16
Penerbit: The Indonesian Society of Internal Medicine
Bahasa: eng

Abstrak

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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Adiana Mutamsari Witaningrum	Afiliasi tidak diketahui	8
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	<dc:title xml:lang="en-US">Genotypic Analysis of Transmitted and Acquired HIV Drug Resistance in People Living with HIV/AIDS  in Surabaya, Indonesia, from 2018 to 2019</dc:title>
	<dc:creator>Rachman, Brian Eka</dc:creator>
	<dc:creator>Megasari, Ni Luh Ayu</dc:creator>
	<dc:creator>Khairunisa, Siti Qamariyah</dc:creator>
	<dc:creator>Kotaki, Tomohiro</dc:creator>
	<dc:creator>Arfijanto, M Vitanata</dc:creator>
	<dc:creator>Hadi, Usman</dc:creator>
	<dc:creator>Nasronudin, Nasronudin</dc:creator>
	<dc:creator>Kameoka, Masanori</dc:creator>
	<dc:subject xml:lang="en-US">HIV-1</dc:subject>
	<dc:subject xml:lang="en-US">Surabaya</dc:subject>
	<dc:subject xml:lang="en-US">antiretroviral therapy (ART)</dc:subject>
	<dc:subject xml:lang="en-US">transmitted HIV drug resistance (TDR)</dc:subject>
	<dc:subject xml:lang="en-US">acquired HIV drug resistance (ADR)</dc:subject>
	<dc:subject xml:lang="en-US">HIV drug resistance</dc:subject>
	<dc:description xml:lang="en-US">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.</dc:description>
	<dc:publisher xml:lang="en-US">The Indonesian Society of Internal Medicine</dc:publisher>
	<dc:date>2024-07-16</dc:date>
	<dc:type>info:eu-repo/semantics/article</dc:type>
	<dc:type>info:eu-repo/semantics/publishedVersion</dc:type>
	<dc:type xml:lang="en-US">Molecular epidemiological study</dc:type>
	<dc:format>application/pdf</dc:format>
	<dc:identifier>http://www.actamedindones.org/index.php/ijim/article/view/2551</dc:identifier>
	<dc:source xml:lang="en-US">Acta Medica Indonesiana; Vol. 56 No. 2 (2024): Acta Medica Indonesiana; 168</dc:source>
	<dc:source>2338-2732</dc:source>
	<dc:source>0125-9326</dc:source>
	<dc:language>eng</dc:language>
	<dc:relation>http://www.actamedindones.org/index.php/ijim/article/view/2551/pdf</dc:relation>
	<dc:rights xml:lang="en-US">Copyright (c) 2024 Brian Eka Rachman, Ni Luh Ayu Megasari, Siti Qamariyah Khairunisa, Tomohiro Kotaki, M. Vitanata Arfijanto, Usman Hadi, _ Nasronudin, Masanori Kameoka</dc:rights>
</oai_dc:dc>