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image of Correlation between Antiretroviral Therapy Responses and Resistance to First-Line Reverse Transcriptase Inhibitors in People Living with HIV-1 Experiencing Virological Failure in South Sulawesi, Indonesia

Abstract

Introduction

The effectiveness of antiretroviral therapy (ART) in treating HIV is influenced by the clinical response of patients, which, in turn, impacts the development of drug resistance. This study aimed to assess the correlation between clinical treatment response and resistance to first-line reverse transcriptase inhibitors in HIV patients receiving treatment for ≤12 and >12 months in South Sulawesi, a province in Indonesia.

Methods

In this cross-sectional study, 36 people living with HIV (PLHIV) experiencing virological failure (VF) were sampled from HIV services in the province from August 2022 to January 2023. HIV-1 viral RNAs were extracted, sequenced, and analyzed for drug sensitivity and resistance classification using the Stanford University HIV Drug Resistance Database (HIVdb) according to World Health Organization (WHO) recommendations, determining resistance levels and HIV subtypes. Phylogenetic analysis of PR-RT sequences (~1200 base pairs) was performed using the Muscle program and MEGA11 software, utilizing the neighbor-joining method with the Kimura two-parameter model.

Results

Genotyping of plasma samples revealed that a significant proportion of patients exhibited mutations associated with resistance to both nucleoside reverse transcriptase inhibitors (NRTIs) and non-NRTIs (NNRTIs) (48.6% and 51.4%, respectively). Clinical response indicators, such as initial body mass index and occurrence of opportunistic infections, were found to correlate with specific drug resistance, highlighting the importance of monitoring treatment response. Moreover, virologic response showed strong associations with resistance to specific drugs, suggesting the need for tailored therapeutic approaches. Patient behaviors related to transmission risk factors were also found to be linked to resistance levels, underscoring the multifactorial nature of resistance development.

Conclusion

Overall, this study underscores the importance of considering treatment response in managing HIV and suggests implications for optimizing therapy regimens to mitigate resistance emergence.

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2025-05-26
2025-10-18

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References

  1. Miti S. Handema R. Mulenga L. Prevalence and characteristics of HIV drug resistance among antiretroviral treatment (ART) experienced adolescents and young adults living with HIV in Ndola, Zambia. PLoS One 2020 15 8 e0236156 10.1371/journal.pone.0236156 32804970
    [Google Scholar]
  2. WHO HIV drug resistance network steering group meeting report. 2021. Available from: https://www.who.int/citations-detail-redirect/9789240038547
  3. RAN Pengendalian HIV AIDS PIMS di Indonesia Tahun 2020-2024. 2024 Available from:https://hivaids-pimsindonesia.or.id/ran-pengendalian-hiv-aids-pims-di-indonesia-tahun-20202024
  4. Regulation of Ministry of Health Republic of Indonesia number 87 year 2014 concerning antiretroviral guideline (in Bahasa Indonesia) 2014 Available from: https://siha.kemkes.go.id/portal/files_upload/Buku_Permenkes_ARV_Cetak.pdf
  5. Consolidated guidelines on the use of antiretroviral drugs for treating and preventing HIV infection: Recommendations for a public health approach 2016 Available from: https://iris.who.int/handle/10665/208825
  6. Guidelines for the Use of Antiretroviral Agents in Adults and Adolescents with HIV Available from: https://clinicalinfo.hiv.gov/sites/default/files/guidelines/documents/adult-adolescent-arv/guidelines-adult-adolescent-arv.pdf
  7. Fact Sheet HIV drug resistance. Available from: https://www.who.int/news-room/fact-sheets/detail/hiv-drug-resistance
    [Google Scholar]
  8. Hong S.Y. Srikantiah P. Abeyewickreme I. Bertagnolio S. Jordan M.R. Systematic review of HIV drug resistance in Southeast Asia. AIDS Rev. 2013 15 3 162 170 24002200
    [Google Scholar]
  9. Antiretroviral therapy for HIV infection in infants and children - 2010. Available from: https://www.who.int/citations-detail-redirect/9789241599801
  10. Nurjannah S. Jayanti S. Tanoerahardjo F.S. Al Musyahadah U.S. Sukowati C.H.C. Massi M.N. 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 2 31 39 10.1007/s11904‑023‑00687‑5 38244171
    [Google Scholar]
  11. Merati T.P. Karyana M. Tjitra E. Prevalence of HIV infection and resistance mutations in patients hospitalized for febrile illness in Indonesia. Am. J. Trop. Med. Hyg. 2021 105 4 960 965 10.4269/ajtmh.20‑1595 34460416
    [Google Scholar]
  12. Chen M. Wu M. Zeng L. Virologic status and pattern of drug resistance mutation among ART-experienced HIV-infected patients in Butuo County, China. J. Glob. Antimicrob. Resist. 2023 32 98 103 10.1016/j.jgar.2023.01.002 36708768
    [Google Scholar]
  13. Clutter D.S. Jordan M.R. Bertagnolio S. Shafer R.W. HIV-1 drug resistance and resistance testing. Infect. Genet. Evol. 2016 46 292 307 10.1016/j.meegid.2016.08.031 27587334
    [Google Scholar]
  14. Kusumaningrum A. Ibrahim F. Yunihastuti E. Bela B. HIV Drug resistance after failure of 6 month first-line therapy in a hospital: A case series. Acta Med. Indones. 2019 51 3 253 257 31699949
    [Google Scholar]
  15. Pham Q.D. Huynh T.K.H. Luong T.T. Tran T. Vu T.X. Truong L.X.T. HIV-1 drug resistance and associated factors among adults failing first-line highly active antiretroviral therapy in Ho Chi Minh City, Vietnam. HIV Clin. Trials 2013 14 1 34 44 10.1310/hct1401‑34 23372113
    [Google Scholar]
  16. Global progress report on HIV, viral hepatitis and sexually transmit-ted infections, 2021 Availbale from: https://www.who.int/citations-detail-redirect/9789240027077
  17. Koethe J.R. Heimburger D.C. Nutritional aspects of HIV-associated wasting in sub-Saharan Africa. Am. J. Clin. Nutr. 2010 91 4 1138S 1142S 10.3945/ajcn.2010.28608D 20147470
    [Google Scholar]
  18. Kyaw N.T.T. Kumar A.M.V. Harries A.D. Synergy between low BMI and hyperglycemia at baseline increases tuberculosis incidence among people living with HIV. AIDS 2022 36 1 117 125 10.1097/QAD.0000000000003090 34586087
    [Google Scholar]
  19. Gallant J.E. DeJesus E. Arribas J.R. Tenofovir DF, emtricitabine, and efavirenz vs. zidovudine, lamivudine, and efavirenz for HIV. N. Engl. J. Med. 2006 354 3 251 260 10.1056/NEJMoa051871 16421366
    [Google Scholar]
  20. Marconi V.C. Sunpath H. Lu Z. Prevalence of HIV-1 drug resistance after failure of a first highly active antiretroviral therapy regimen in KwaZulu Natal, South Africa. Clin. Infect. Dis. 2008 46 10 1589 1597 10.1086/587109 18419495
    [Google Scholar]
  21. Geretti AM Case studies Antiretroviral Resistance in Clinical Practice 2006
    [Google Scholar]
/content/journals/chr/10.2174/011570162X336531250517171339
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Correlation between Antiretroviral Therapy Responses and Resistance to First-Line Reverse Transcriptase Inhibitors in People Living with HIV-1 Experiencing Virological Failure in South Sulawesi, Indonesia
Bentham Science Publishers ; https://doi.org/10.2174/011570162X336531250517171339
/content/journals/chr/10.2174/011570162X336531250517171339
/content/journals/chr/10.2174/011570162X336531250517171339
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  • Article Type:     Research Article
Keywords: HIV drug resistance ; virological failure (VF) ; Treatment response ; reverse transcriptase inhibitors ; people living with HIV (PLHIV) ; antiretroviral therapy (ART)

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