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Khairunisa SQ, Indriati DW, Megasari NLA, Ueda S, Kotaki T, Fahmi M, Ito M, Rachman BE, Hidayati AN, Nasronudin, Kameoka M. Spatial-temporal transmission dynamics of HIV-1 CRF01_AE in Indonesia. Sci Rep 2024; 14:9917. [PMID: 38730038 PMCID: PMC11087524 DOI: 10.1038/s41598-024-59820-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/03/2023] [Accepted: 04/16/2024] [Indexed: 05/12/2024] Open
Abstract
Human immunodeficiency virus type 1 (HIV-1) remains a serious health threat in Indonesia. In particular, the CRF01_AE viruses were the predominant HIV-1 strains in various cities in Indonesia. However, information on the dynamic transmission characteristics and spatial-temporal transmission of HIV-1 CRF01_AE in Indonesia is limited. Therefore, the present study examined the spatial-temporal transmission networks and evolutionary characteristics of HIV-1 CRF01_AE in Indonesia. To clarify the epidemiological connection between CRF01_AE outbreaks in Indonesia and the rest of the world, we performed phylogenetic studies on nearly full genomes of CRF01_AE viruses isolated in Indonesia. Our results showed that five epidemic clades, namely, IDN clades 1-5, of CRF01_AE were found in Indonesia. To determine the potential source and mode of transmission of CRF01_AE, we performed Bayesian analysis and built maximum clade credibility trees for each clade. Our study revealed that CRF01_AE viruses were commonly introduced into Indonesia from Southeast Asia, particularly Thailand. The CRF01_AE viruses might have spread through major pandemics in Asian countries, such as China, Vietnam, and Laos, rather than being introduced directly from Africa in the early 1980s. This study has major implications for public health practice and policy development in Indonesia. The contributions of this study include understanding the dynamics of HIV-1 transmission that is important for the implementation of HIV disease control and prevention strategies in Indonesia.
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Affiliation(s)
- Siti Qamariyah Khairunisa
- Faculty of Medicine, Universitas Airlangga, Surabaya, Indonesia
- Indonesian-Japan Collaborative Research Center for Emerging and Re-Emerging Infectious Diseases, Institute of Tropical Disease, Universitas Airlangga, Surabaya, Indonesia
| | - Dwi Wahyu Indriati
- Indonesian-Japan Collaborative Research Center for Emerging and Re-Emerging Infectious Diseases, Institute of Tropical Disease, Universitas Airlangga, Surabaya, Indonesia
- Department of Health, Vocational Faculty, Universitas Airlangga, Surabaya, Indonesia
| | - Ni Luh Ayu Megasari
- Indonesian-Japan Collaborative Research Center for Emerging and Re-Emerging Infectious Diseases, Institute of Tropical Disease, Universitas Airlangga, Surabaya, Indonesia
- Postgraduate School, Universitas Airlangga, Surabaya, Indonesia
| | - Shuhei Ueda
- Indonesian-Japan Collaborative Research Center for Emerging and Re-Emerging Infectious Diseases, Institute of Tropical Disease, Universitas Airlangga, Surabaya, Indonesia
- Center for Infectious Diseases, Kobe University Graduate School of Medicine, Hyogo, Japan
- Department of Public Health, Kobe University Graduate School of Health Sciences, 7-10-2 Tomogaoka, Suma-ku, Kobe, Hyogo, 654-0142, Japan
| | - Tomohiro Kotaki
- Indonesian-Japan Collaborative Research Center for Emerging and Re-Emerging Infectious Diseases, Institute of Tropical Disease, Universitas Airlangga, Surabaya, Indonesia
- Department of Public Health, Kobe University Graduate School of Health Sciences, 7-10-2 Tomogaoka, Suma-ku, Kobe, Hyogo, 654-0142, Japan
- Department of Virology, Research Institute for Microbial Diseases, Osaka University, Osaka, Japan
| | - Muhamad Fahmi
- Research Department, Research Institute for Humanity and Nature, Kyoto, Japan
- Research Organization of Science and Technology, Ritsumeikan University, Kusatsu, Japan
| | - Masahiro Ito
- Department of Bioinformatics, College of Life Sciences, Ritsumeikan University, Kusatsu, Japan
| | - Brian Eka Rachman
- Faculty of Medicine, Universitas Airlangga, Surabaya, Indonesia
- Indonesian-Japan Collaborative Research Center for Emerging and Re-Emerging Infectious Diseases, Institute of Tropical Disease, Universitas Airlangga, Surabaya, Indonesia
| | - Afif Nurul Hidayati
- Faculty of Medicine, Universitas Airlangga, Surabaya, Indonesia
- Indonesian-Japan Collaborative Research Center for Emerging and Re-Emerging Infectious Diseases, Institute of Tropical Disease, Universitas Airlangga, Surabaya, Indonesia
| | - Nasronudin
- Faculty of Medicine, Universitas Airlangga, Surabaya, Indonesia.
- Indonesian-Japan Collaborative Research Center for Emerging and Re-Emerging Infectious Diseases, Institute of Tropical Disease, Universitas Airlangga, Surabaya, Indonesia.
| | - Masanori Kameoka
- Indonesian-Japan Collaborative Research Center for Emerging and Re-Emerging Infectious Diseases, Institute of Tropical Disease, Universitas Airlangga, Surabaya, Indonesia.
- Department of Public Health, Kobe University Graduate School of Health Sciences, 7-10-2 Tomogaoka, Suma-ku, Kobe, Hyogo, 654-0142, Japan.
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Nurjannah, Jayanti S, Tanoerahardjo FS, Al Musyahadah US, Sukowati CHC, Massi MN. Major Drug Resistance Mutations on Reverse Transcriptase Gene in Human Immunodeficiency Virus Type-1 in Indonesia: A Systematic Review. Curr HIV/AIDS Rep 2024; 21:31-39. [PMID: 38244171 DOI: 10.1007/s11904-023-00687-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 12/29/2023] [Indexed: 01/22/2024]
Abstract
PURPOSE OF REVIEW The prevalence of HIV-1 in Indonesia is on a concerning upward trajectory, with a concurrent rise in the development of drug-resistant strains, challenging the efficacy of antiretroviral therapy (ART). Many mutations have been found in the pol gene that makes HIV resistant to ART. We aim to review the major drug resistance mutations (DRMs) of reverse transcriptase (RT) of pol gene in HIV-1 cases in Indonesia. RECENT FINDINGS A total of eleven articles reporting DRMs in HIV-1 subjects from various regions between 2015-2020 in Indonesia are included. The prevalence of major DRMs on the RT gene in studies included varies from 3.4% to 34%. The CRF01_AE subtype stands out as the predominant variant. Notably, the prevalence of major DRMs in ART-experienced individuals is 22.1%, while ART-naïve individuals show a lower rate of 4.4%. Among the RT gene mutations, M184I/V emerges as the most prevalent (10.5%) within the nucleos(t)ide reverse transcriptase inhibitors (NRTI) group, while K103N leads among the non-NRTI (NNRTI) group, with a frequency of 6.4%. Regionally, North Sulawesi records the highest prevalence of major DRMs in the RT gene at 21.1%, whereas Riau and Central Papua exhibit the lowest rates at 3.4%. Significant variations in drug resistance mutations within the RT gene across Indonesian regions highlight the importance of closely monitoring and evaluating the effectiveness of current antiretroviral therapy (ART) regimens. Considerably, more studies are needed to understand better and overcome the emergence of DRMs on HIV-1 patients in Indonesia.
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Affiliation(s)
- Nurjannah
- Postgraduate School, Hasanuddin University, Makassar, 90245, Indonesia
- Ministry of Health of Republic Indonesia, Jakarta Selatan, 12950, Indonesia
| | - Sri Jayanti
- Eijkman Research Center for Molecular Biology, National Research and Innovation Agency, Cibinong, 16911, Indonesia
| | | | - Ummu Syauqah Al Musyahadah
- Department of Bioinformatics, Faculty of Health Technology, University of Megarezky, Makassar, 90234, Indonesia
| | - Caecilia Hapsari Ceriapuri Sukowati
- Eijkman Research Center for Molecular Biology, National Research and Innovation Agency, Cibinong, 16911, Indonesia
- Liver Cancer Unit, Fondazione Italiana Fegato ONLUS, AREA Science Park, 34149, Trieste, Italy
| | - Muhammad Nasrum Massi
- Department of Clinical Microbiology, Hasanuddin University, Makassar, 90245, Indonesia.
- Microbiology Laboratory, Hasanuddin University Hospital, Makassar, 90245, Indonesia.
- Hasanuddin University Medical Research Center Laboratory, Faculty of Medicine, Hasanuddin University, Makassar, 90245, Indonesia.
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Khairunisa SQ, Megasari NLA, Ueda S, Budiman W, Kotaki T, Nasronudin, Kameoka M. 2018-2019 Update on the Molecular Epidemiology of HIV-1 in Indonesia. AIDS Res Hum Retroviruses 2020; 36:957-963. [PMID: 32799643 DOI: 10.1089/aid.2020.0151] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
Abstract
The HIV type 1 (HIV-1) epidemic has continued to grow in Indonesia; however, continuous updates on the epidemiology of HIV-1 in Indonesia remain challenging because it is the biggest archipelago in the world. Furthermore, the emergence of HIV drug resistance (HIVDR) has had a negative impact on the treatment of infected individuals. In this study, we performed HIV-1 subtyping and the detection of HIVDR in 105 HIV-1-infected individuals residing in various cities in Indonesia during 2018-2019. The results obtained identified CRF01_AE as the major epidemic HIV-1 strain, responsible for 81.9% of infection cases, followed by subtype B (12.4%), CRF02_AG (3.8%), CRF52_01B (1%), and a recombinant between CRF01_AE and CRF02_AG (1.0%). Major drug resistance-associated mutations against reverse transcriptase inhibitors were detected in 20% of samples. These results suggest that CRF01_AE is a major HIV-1 strain in Indonesia, while CRF02_AG is emerging. The prevalence of HIVDR in Indonesia needs to be monitored.
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Affiliation(s)
- Siti Qamariyah Khairunisa
- Indonesian-Japan Collaborative Research Center for Emerging and Re-emerging Infectious Diseases, Institute of Tropical Disease, Universitas Airlangga, Surabaya, Indonesia
| | - Ni Luh Ayu Megasari
- Indonesian-Japan Collaborative Research Center for Emerging and Re-emerging Infectious Diseases, Institute of Tropical Disease, Universitas Airlangga, Surabaya, Indonesia
| | - Shuhei Ueda
- Indonesian-Japan Collaborative Research Center for Emerging and Re-emerging Infectious Diseases, Institute of Tropical Disease, Universitas Airlangga, Surabaya, Indonesia
- Center for Infectious Diseases, Kobe University Graduate School of Medicine, Hyogo, Japan
- Department of Public Health, Kobe University Graduate School of Health Sciences, Hyogo, Japan
| | | | - Tomohiro Kotaki
- Department of Public Health, Kobe University Graduate School of Health Sciences, Hyogo, Japan
| | - Nasronudin
- Indonesian-Japan Collaborative Research Center for Emerging and Re-emerging Infectious Diseases, Institute of Tropical Disease, Universitas Airlangga, Surabaya, Indonesia
- Faculty of Medicine, Universitas Airlangga, Surabaya, Indonesia
| | - Masanori Kameoka
- Department of Public Health, Kobe University Graduate School of Health Sciences, Hyogo, Japan
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Khairunisa SQ, Megasari NLA, Indriati DW, Kotaki T, Natalia D, Nasronudin, Kameoka M. Identification of HIV-1 subtypes and drug resistance mutations among HIV-1-infected individuals residing in Pontianak, Indonesia. Germs 2020; 10:174-183. [PMID: 33134195 DOI: 10.18683/germs.2020.1203] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/10/2020] [Revised: 07/15/2020] [Accepted: 07/20/2020] [Indexed: 11/08/2022]
Abstract
Introduction The present study investigated the HIV-1 subtype classification in addition to prevalence of drug resistance mutations (DRMs) in antiretroviral therapy (ART)-experienced and ART-naïve residents of Pontianak, West Kalimantan, Indonesia. Methods Whole blood samples collected from 30 HIV-1-infected individuals, comprising 19 ART-experienced and 11 ART-naïve individuals, were subjected to RNA and DNA extraction, followed by HIV-1 genes amplification and sequencing analysis. HIV-1 subtyping was classified on viral pol genes encoding reverse transcriptase (RT gene) and protease (PR gene) accompanied by the env and gag genes. DRMs in the RT and PR genes were also analyzed. Results CRF01_AE was identified as the predominant circulating recombinant form (CRF) of HIV-1 in both ART-experienced and ART-naïve individuals. In addition, CRF02_AG, subtype B, recombinant virus expressing CRF01_AE and subtype B viral genomic fragments, also recombinant virus containing CRF01_AE and CRF02_AG genomic fragments were also identified. Acquired drug resistance (ADR) was identified in 28.5% of ART-experienced individuals, while no transmitted drug resistance was identified in ART-naïve individuals. Conclusions This study identified CRF01_AE as the most predominant HIV-1 CRF distributing in Pontianak, Indonesia. The prevalence of ADR is considered to be high; thus, further surveillance is needed in this region.
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Affiliation(s)
- Siti Qamariyah Khairunisa
- BSc, MSc, Doctoral Program - Faculty of Medicine, Universitas Airlangga, Surabaya 60286, Indonesia; Indonesian-Japan Collaborative Research Center for Emerging and Re-emerging Infectious Diseases, Institute of Tropical Disease, Universitas Airlangga, Surabaya 60115, Indonesia
| | - Ni Luh Ayu Megasari
- BSND, MTropMed, PhD, Indonesian-Japan Collaborative Research Center for Emerging and Re-emerging Infectious Diseases, Institute of Tropical Disease, Universitas Airlangga, Surabaya 60115, Indonesia
| | - Dwi Wahyu Indriati
- BSc, PhD, Indonesian-Japan Collaborative Research Center for Emerging and Re-emerging Infectious Diseases, Institute of Tropical Disease, Universitas Airlangga, Surabaya 60115, Indonesia
| | - Tomohiro Kotaki
- PhD, Assistant Professor, Division of Global Infectious Diseases, Department of Public Health, Kobe University Graduate School of Health Sciences, Kobe, Hyogo 654-0142, Japan
| | - Diana Natalia
- MD, Department of Parasitology, Faculty of Medicine, Universitas Tanjung Pura, Pontianak 78124, Indonesia
| | - Nasronudin
- MD, PhD, Professor, Faculty of Medicine, Universitas Airlangga, Surabaya 60115, Indonesia; Indonesian-Japan Collaborative Research Center for Emerging and Re-emerging Infectious Diseases, Institute of Tropical Disease, Universitas Airlangga, Surabaya 60115, Indonesia
| | - Masanori Kameoka
- PhD, Professor, Division of Global Infectious Diseases, Department of Public Health, Kobe University Graduate School of Health Sciences, 7-10-2 Tomogaoka, Suma-ku, Kobe, Hyogo 654-0142, Japan
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Khairunisa SQ, Megasari NLA, Rahayu RP, Witaningrum AM, Ueda S, Yunifiar M MQ, Indriati DW, Kotaki T, Rusli A, Nasronudin, Kameoka M. Detection of human immunodeficiency virus type 1 transmitted drug resistance among treatment-naive individuals residing in Jakarta, Indonesia. Infect Dis Rep 2020; 12:8740. [PMID: 32874468 PMCID: PMC7447941 DOI: 10.4081/idr.2020.8740] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/17/2020] [Accepted: 07/01/2020] [Indexed: 12/02/2022] Open
Abstract
The presence of transmitted drug resistance (TDR) in human immunodeficiency virus type 1 (HIV-1) infected individuals naive to antiretroviral therapy, may affect the effectiveness of treatment. Jakarta, the capital city of Indonesia, recorded the highest number of cumulative HIV infection cases in the country. This study aimed to identify on the appearance of TDR, as well as to identify HIV-1 subtypes circulating among treatment-naive individuals in Jakarta. Whole blood samples collected from 43 HIV-1 infected, treatment-naive individuals. Viral subtyping and drug resistance testing were performed on HIV-1 pol genes amplified using nested polymerase chain reaction. CRF01_AE was detected most frequently in Jakarta (73.08%). Drug resistance-related major mutation was not detected in protease fragments of pol gene, but two major mutations, K103N (6.67%) and Y181C (6.67%), were detected in reverse transcriptase fragments of pol gene. Our results suggest that TDR was emerged in Jakarta at a certain extent, thus further surveillance study to monitor the TDR prevalence and circulating HIV-1 subtypes in this region is considered to be necessary.
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Affiliation(s)
- Siti Qamariyah Khairunisa
- Doctoral Program,Faculty of Medicine, Universitas Airlangga, Surabaya
- Indonesia-Japan Collaborative Research Centre for Emerging and Reemerging Infectious Diseases (CRCERI), Institute of Tropical Disease, Universitas Airlangga, Surabaya, Indonesia
| | - Ni Luh Ayu Megasari
- Indonesia-Japan Collaborative Research Centre for Emerging and Reemerging Infectious Diseases (CRCERI), Institute of Tropical Disease, Universitas Airlangga, Surabaya, Indonesia
| | - Retno Pudji Rahayu
- Indonesia-Japan Collaborative Research Centre for Emerging and Reemerging Infectious Diseases (CRCERI), Institute of Tropical Disease, Universitas Airlangga, Surabaya, Indonesia
| | - Adiana Mutamsari Witaningrum
- Indonesia-Japan Collaborative Research Centre for Emerging and Reemerging Infectious Diseases (CRCERI), Institute of Tropical Disease, Universitas Airlangga, Surabaya, Indonesia
| | - Shuhei Ueda
- Indonesia-Japan Collaborative Research Centre for Emerging and Reemerging Infectious Diseases (CRCERI), Institute of Tropical Disease, Universitas Airlangga, Surabaya, Indonesia
- Department of Public Health
- Center for Infectious Diseases, Kobe University Graduate School of Medicine, Hyogo, Japan
| | - Muhammad Qushai Yunifiar M
- Indonesia-Japan Collaborative Research Centre for Emerging and Reemerging Infectious Diseases (CRCERI), Institute of Tropical Disease, Universitas Airlangga, Surabaya, Indonesia
| | - Dwi Wahyu Indriati
- Indonesia-Japan Collaborative Research Centre for Emerging and Reemerging Infectious Diseases (CRCERI), Institute of Tropical Disease, Universitas Airlangga, Surabaya, Indonesia
- Department of Health, Vocational Faculty
| | | | - Adria Rusli
- Sulianti Saroso Hospital, Jakarta, Indonesia
| | - Nasronudin
- Indonesia-Japan Collaborative Research Centre for Emerging and Reemerging Infectious Diseases (CRCERI), Institute of Tropical Disease, Universitas Airlangga, Surabaya, Indonesia
- Airlangga Hospital, Universitas Airlangga, Surabaya, Indonesia
| | - Masanori Kameoka
- Indonesia-Japan Collaborative Research Centre for Emerging and Reemerging Infectious Diseases (CRCERI), Institute of Tropical Disease, Universitas Airlangga, Surabaya, Indonesia
- Department of Public Health
- Center for Infectious Diseases, Kobe University Graduate School of Medicine, Hyogo, Japan
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Ueda S, Witaningrum AM, Khairunisa SQ, Kotaki T, Motomura K, Nasronudin, Kameoka M. Transmission dynamics of HIV-1 subtype B strains in Indonesia. Sci Rep 2019; 9:13986. [PMID: 31562375 PMCID: PMC6764962 DOI: 10.1038/s41598-019-50491-8] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/15/2019] [Accepted: 09/13/2019] [Indexed: 11/09/2022] Open
Abstract
Human immunodeficiency virus type 1 (HIV-1) and acquired immunodeficiency syndrome (AIDS) represent a major public health concern in Indonesia. Although circulating recombinant form (CRF) 01_AE is a predominant subtype in Indonesia, HIV-1 subtype B (HIV-1B) is also widely prevalent. However, the viral genetic evolution, spatial origins, and patterns of transmission of HIV-1B in Indonesia remain unclear. In the present study, we described the evolutionary characteristics and spatial-temporal transmission networks of HIV-1B in Indonesia. To elucidate the epidemiological link between HIV-1B epidemics in Indonesia and those in the remainder of the world, we conducted phylogenetic analyses of HIV-1B strains in Indonesia. Based on the results obtained, at least three epidemic clades [the Indonesia, United States (US), and China clades] of HIV-1B were found to be prevalent in Indonesia. In order to identify the potential source and transmission route of Indonesian HIV-1B strains, we performed Bayesian analyses and constructed Maximum clade credibility trees of each clade. Although some HIV-1B strains in Indonesia were introduced from Thailand, the prevalent HIV-1B strains appeared to have been directly introduced from Europe or America. Indonesian HIV-1B may have spread via the main dispersal of pandemic HIV-1B strains via the US from the Caribbean region rather than being directly introduced from Africa.
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Affiliation(s)
- Shuhei Ueda
- Department of Public Health, Kobe University Graduate School of Health Sciences, Hyogo, Japan.,Center for Infectious Diseases, Kobe University Graduate School of Medicine, Hyogo, Japan.,Indonesia-Japan Collaborative Research Center for Emerging and Re-emerging Infectious Diseases, Institute of Tropical Disease, Universitas Airlangga, Surabaya, Indonesia
| | - Adiana Mutamsari Witaningrum
- Indonesia-Japan Collaborative Research Center for Emerging and Re-emerging Infectious Diseases, Institute of Tropical Disease, Universitas Airlangga, Surabaya, Indonesia
| | - Siti Qamariyah Khairunisa
- Indonesia-Japan Collaborative Research Center for Emerging and Re-emerging Infectious Diseases, Institute of Tropical Disease, Universitas Airlangga, Surabaya, Indonesia
| | - Tomohiro Kotaki
- Department of Public Health, Kobe University Graduate School of Health Sciences, Hyogo, Japan.,Indonesia-Japan Collaborative Research Center for Emerging and Re-emerging Infectious Diseases, Institute of Tropical Disease, Universitas Airlangga, Surabaya, Indonesia
| | | | - Nasronudin
- Indonesia-Japan Collaborative Research Center for Emerging and Re-emerging Infectious Diseases, Institute of Tropical Disease, Universitas Airlangga, Surabaya, Indonesia.,Faculty of Medicine, Universitas Airlangga, Surabaya, Indonesia.,Airlangga Hospital, Surabaya, Indonesia
| | - Masanori Kameoka
- Department of Public Health, Kobe University Graduate School of Health Sciences, Hyogo, Japan. .,Center for Infectious Diseases, Kobe University Graduate School of Medicine, Hyogo, Japan.
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Budayanti NS, Merati TP, Bela B, Mahardika GN. Molecular Antiretroviral Resistance Markers of Human Immunodeficiency Virus-1 of CRF01_AE Subtype in Bali, Indonesia. Curr HIV Res 2019; 16:374-382. [PMID: 30714528 PMCID: PMC6446452 DOI: 10.2174/1570162x17666190204101154] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/08/2018] [Revised: 01/27/2019] [Accepted: 01/30/2019] [Indexed: 11/22/2022]
Abstract
Background: Molecular epidemiological study of human immunodeficiency virus drug-resistant (HIVDR) markers is challenging in areas where the dominant subtype is non-B. Objective: Here we provide molecular data for HIVDR in the CRF01_AE subtype in Bali, Indonesia. Method: Seventy patients were enrolled in this study and grouped into treatment failure and treatment naïve groups. The full-length pol gene was amplified using nested reverse transcriptase polymerase chain reaction and the product was then sequenced. The readable sequence was then subjected to Stan-ford HIV Drug Resistance Database genotyping. Results: We found that clinical classification was in accordance with the presence of HIVDR markers in the pol gene. Independent of therapy history, the treatment failure group showed resistance markers against nucleoside reverse transcriptase inhibitors (NRTI) and non-nucleoside reverse transcriptase in-hibitors (NNRTI), ranging from 72%–100% of patients. Only a small proportion of naïve patients harbored HIV with drug resistance markers to NNRTI. No protease inhibitor-resistant marker was found in either patient group. Molecular marker mutations, which were found in more than 50% of treatment failure patients, were M184V (100%), T215A/Y/F (88.2%), D67N/G (76.5%), and M41L (58.8%). Conclusion: The protocol used in this study to determine genetic markers of HIVDR based on sub-type B can be applied for the rapid determination of resistance of the CRF01_AE subtype. All patients with progressive clinical signs and increased viral load should be recommended to undergo second-line treatment of the ARV regimen.
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Affiliation(s)
- Nyoman Sri Budayanti
- Microbiology Department, Faculty of Medicine, Udayana University, Jl. PB Sudirman, Denpasar, Bali, Indonesia
| | - Tuti Parwati Merati
- Internal Medicine Department, Faculty of Medicine, Udayana University, Jl. PB Sudirman, Denpasar, Bali, Indonesia
| | - Budiman Bela
- Microbiology Department, Faculty of Medicine, Indonesia University, Jakarta, Indonesia
| | - Gusti Ngurah Mahardika
- Animal Biomedical and Molecular Biology Laboratory, Faculty of Veterinary Medicine, Udayana University, Jl. Sesetan-Markisa 6, Denpasar 80226, Bali, Indonesia
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Ueda S, Witaningrum AM, Khairunisa SQ, Kotaki T, Nasronudin, Kameoka M. Genetic Diversity and Drug Resistance of HIV-1 Circulating in North Sulawesi, Indonesia. AIDS Res Hum Retroviruses 2019; 35:407-413. [PMID: 30229669 DOI: 10.1089/aid.2018.0221] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
Abstract
Manado, the capital city of North Sulawesi, is a unique region in Indonesia because of its religion. We collected peripheral blood samples from 63 individuals on antiretroviral therapy. The amplification of viral genomic fragments, viral subtyping, detection of HIV drug resistance-associated mutations (DRAMs), and phylogenetic analyses were performed. Viral subtyping revealed that the most prevalent HIV type 1 (HIV-1) subtype/circulating recombinant form (CRF) was CRF01_AE (84.1%), followed by subtype B (6.8%) and recombinants between CRF01_AE and CRF02_AG (4.5%). Although no major DRAMs were present in protease genes, they were detected in reverse transcriptase (RT) genes. Nine of 38 samples (23.7%) had major DRAMs against nucleoside RT inhibitors (NRTIs) and/or non-NRTIs. The results of phylogenetic analyses indicated that CRF01_AE in North Sulawesi is related to that in Bali. Therefore, Bali may play an important role in circulating CRF01_AE in North Sulawesi.
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Affiliation(s)
- Shuhei Ueda
- Department of Public Health, Kobe University Graduate School of Health Sciences, Hyogo, Japan
- Center for Infectious Diseases, Kobe University Graduate School of Medicine, Hyogo, Japan
- Indonesia-Japan Collaborative Research Center for Emerging and Re-emerging Infectious Diseases, Institute of Tropical Disease, Airlangga University, Surabaya, Indonesia
| | - Adiana Mutamsari Witaningrum
- Indonesia-Japan Collaborative Research Center for Emerging and Re-emerging Infectious Diseases, Institute of Tropical Disease, Airlangga University, Surabaya, Indonesia
| | - Siti Qamariyah Khairunisa
- Indonesia-Japan Collaborative Research Center for Emerging and Re-emerging Infectious Diseases, Institute of Tropical Disease, Airlangga University, Surabaya, Indonesia
| | - Tomohiro Kotaki
- Department of Public Health, Kobe University Graduate School of Health Sciences, Hyogo, Japan
- Indonesia-Japan Collaborative Research Center for Emerging and Re-emerging Infectious Diseases, Institute of Tropical Disease, Airlangga University, Surabaya, Indonesia
| | - Nasronudin
- Indonesia-Japan Collaborative Research Center for Emerging and Re-emerging Infectious Diseases, Institute of Tropical Disease, Airlangga University, Surabaya, Indonesia
- Faculty of Medicine, Airlangga University, Surabaya, Indonesia
- Airlangga Hospital, Surabaya, Indonesia
| | - Masanori Kameoka
- Department of Public Health, Kobe University Graduate School of Health Sciences, Hyogo, Japan
- Center for Infectious Diseases, Kobe University Graduate School of Medicine, Hyogo, Japan
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