Genotypic characterization of human immunodeficiency virus type 1 isolated in Bali, Indonesia in 2016

Abstract

Introduction: Bali is a famous tourism destination in Indonesia, and many international travelers from several foreign countries visit Bali. A large number of human immunodeficiency type 1 (HIV-1) infections was found; however, the genotypes of HIV-1 strains circulating in Bali has not yet been elucidated in detail. In addition, the information on HIV drug resistance (HIVDR) in Bali is limited. Material and methods: HIV-1 pol gene encoding 31 proteases (PR gene) and 37 reverse transcriptase (RT gene) as well as 47 gag and 33 env genes were successfully amplified from DNA samples extracted from peripheral blood mononuclear cells samples of 51 antiretroviral therapy (ART)-experienced and 7 ART-naïve HIV-1-infected individuals residing in Gianyar and Denpasar, Bali. Genotyping analyses were then performed. The assessment of drug resistance mutations was based on the guidelines published by the International Antiviral Society-United States of America (IAS-USA). Results: The major HIV-1 subtype detected in this study was CRF01_AE (94.5%). Recombinant viruses containing CRF01_AE and subtype B genes (5.5%) were also detected. Drug resistance-associated major mutations were detected in 8/31 (25.8%) of RT genes but not in PR genes in integrated proviral DNA derived from ART-experienced individuals. However, drug resistance-associated minor mutations were frequently detected in PR genes derived from most samples. Conclusions: This study revealed that CRF01_AE was the predominant HIV-1 subtype in Bali, Indonesia. In addition, the emergence of drug resistance mutations was evident in proviral DNA derived from ART-experienced individuals, indicating that continuous surveillance is needed in order to monitor the emergence of HIVDR and new viral subtypes in Indonesia.

Correlation of Capute Scores with CD4 Count among Human Immunodeficiency Virus-infected Children in Sanglah Hospital, Bali, Indonesia

“…CD4 count was the easiest predictor factor of the degree of HIV symptoms, and this study showed its positive correlation with Capute score. In line with previous research obtained that there was a positive correlation between cognitive disorders with CD4 levels [9], [10], [11]. Positive correlation also found between CAT scores and CD4 count (r = 0.418 and p = 0.01).…”

Genotypic Characterization of Human Immunodeficiency Virus Type 1 Isolated from Antiretroviral Treatment-Experienced Individuals in Buleleng Regency, Bali, Indonesia

“…CRF01_AE, the second predominant circulating CRF accounting for 5% of infection cases worldwide in 2004-2007, is responsible for the vast majority of infections in Southeast Asia, including several regions in Indonesia. [3][4][5][6][7] Subtypes and CRFs may differ in the rates of disease progression and viral transmission.…”

“…12 Previous studies that focused on Gianyar Regency and Denpasar city in Bali identified CRF01_AE as the major cause of infection, and major drug resistance mutations (DRMs) in the RT gene were detected in 25.8% of ART-experienced individuals. 7 The genotypic characteristics of HIV-1 circulating in tourism-concentrated regions may differ from those in regions less popular for tourism; however, limited information is currently available on HIV-1 subtypes and the prevalence of DRM outside South Bali. Therefore, the present study aimed to Successfully amplified viral genes were then subjected to a sequence analysis performed by Macrogen Japan (http://www.macrogen-japan.co.jp).…”

Detection of Human Immunodeficiency Virus Type 1 Transmitted Drug Resistance among Treatment-Naive Individuals Residing in Jakarta, Indonesia

“…1 As many other countries, HIV infection in Indonesia is mainly caused by HIV type 1 (HIV-1) group M. There are nine subtypes (A, B, C, D, F, G, H, J, and K), as well as circulating recombinant forms (CRFs) and unique recombinant forms (URFs), within the group M. 3 Several studies have reported the dominance of HIV-1 CRF01_AE in several Indonesian regions. [4][5][6][7][8][9][10] As an effort to address the HIV epidemic, Ministry of Health of Indonesia implemented antiretroviral therapy (ART) under national guideline. First-line ART regimen recommended contains two nucleoside reverse transcriptase (RT) inhibitors (NRTIs) and one non-nucleoside RT inhibitor (NNRTI).…”

“…12 The emergence of acquired drug resistance (ADR) in treatment-experienced individuals and transmitted drug resistance (TDR) in treatment-naive individuals residing in several Indonesian regions, including Surabaya, Riau, Bali, and Maumere, has been previously described. [5][6][7][8][9][10] The TDR might disrupt effectiveness of treatment, resulting in unfavorable clinical outcomes. 13 Therefore, it is important to monitor the emergence of TDR by a continuous surveillance in order to secure long-term and stable ART in Indonesia.…”