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Appearance of Drug Resistance Mutations Among the Dominant HIV-1 Subtype, CRF01_AE in Maumere, Indonesia

[ Vol. 16 , Issue. 2 ]

Author(s):

Dwi Wahyu Indriati, Tomohiro Kotaki, Siti Qamariyah Khairunisa, Adiana Mutamsari Witaningrum, Muhammad Qushai Yunifiar Matondang, Shuhei Ueda, Nasronudin, Asep Purnama, Dwi Kurniawan and Masanori Kameoka*   Pages 158 - 166 ( 9 )

Abstract:


Background and Objectives: Human Immunodeficiency Virus (HIV) is still a major health issue in Indonesia. In recent years, the appearance of drug resistance-associated mutations has reduced the effectiveness of Antiretroviral Therapy (ART). We conducted genotypic studies, including the detection of drug resistance-associated mutations (from first-line regimen drugs), on HIV-1 genes derived from infected individuals in Maumere, West Nusa Tenggara. Maumere, a transit city in West Nusa Tenggara, which has a high HIV-1 transmission rate.

Method: We collected 60 peripheral blood samples from 53 ART-experienced and 7 ART-naive individuals at TC Hillers Hospital, Maumere between 2014 and 2015. The amplification and a sequencing analysis of pol genes encoding protease (the PR gene) and reverse transcriptase (the RT gene) as well as the viral env and gag genes were performed. HIV-1 subtyping and the detection of drug resistance-associated mutations were then conducted.

Results: Among 60 samples, 46 PR, 31 RT, 30 env, and 20 gag genes were successfully sequenced. The dominant HIV-1 subtype circulating in Maumere was CRF01_AE. Subtype B and recombinant viruses containing gene fragments of CRF01_AE, subtypes A, B, C, and/or G were also identified as minor populations. The major drug resistance-associated mutations, M184V, K103N, Y188L, and M230I, were found in the RT genes. However, no major drug resistance-associated mutations were detected in the PR genes.

Conclusion: CRF01_AE was the major HIV-1 subtype prevalent in Maumere. The appearance of drug resistance-associated mutations found in the present study supports the necessity of monitoring the effectiveness of ART in Maumere.

Keywords:

HIV-1, CRF01_AE, Antiretroviral Therapy (ART), drug resistance-associated mutations, Maumere, Indonesia.

Affiliation:

Indonesia-Japan Collaborative Research Center for Emerging and Re-emerging Infectious Disease, Institute of Tropical Disease, Universitas Airlangga, Surabaya, Indonesia-Japan Collaborative Research Center for Emerging and Re-emerging Infectious Disease, Institute of Tropical Disease, Universitas Airlangga, Surabaya, Indonesia-Japan Collaborative Research Center for Emerging and Re-emerging Infectious Disease, Institute of Tropical Disease, Universitas Airlangga, Surabaya, Indonesia-Japan Collaborative Research Center for Emerging and Re-emerging Infectious Disease, Institute of Tropical Disease, Universitas Airlangga, Surabaya, Indonesia-Japan Collaborative Research Center for Emerging and Re-emerging Infectious Disease, Institute of Tropical Disease, Universitas Airlangga, Surabaya, Indonesia-Japan Collaborative Research Center for Emerging and Re-emerging Infectious Disease, Institute of Tropical Disease, Universitas Airlangga, Surabaya, Indonesia-Japan Collaborative Research Center for Emerging and Re-emerging Infectious Disease, Institute of Tropical Disease, Universitas Airlangga, Surabaya, TC Hillers Hospital, Maumere, TC Hillers Hospital, Maumere, Center for Infectious Diseases, Kobe University, Graduate School of Medicine, Hyogo

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