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Major Drug Resistance Mutations on Reverse Transcriptase Gene in Human Immunodeficiency Virus Type-1 in Indonesia: A Systematic Review

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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%.

Summary

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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Acknowledgements

The editors would like to thank Dr. Masanori Kameoka for handling the review of this manuscript.

Funding

S.J. has been funded by Manajemen Talenta, Badan Riset dan Inovasi Nasional, Indonesia. C.H.C.S. has been funded by a 2023 grant from the Fondazione Veronesi, Milan, Italy.

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Author notes

  1. Nurjannah and Sri Jayanti share equal contribution.

Authors and Affiliations

  1. Postgraduate School, Hasanuddin University, Makassar, 90245, Indonesia

    Nurjannah & Francisca Srioetami Tanoerahardjo

  2. Ministry of Health of Republic Indonesia, Jakarta Selatan, 12950, Indonesia

    Nurjannah

  3. Eijkman Research Center for Molecular Biology, National Research and Innovation Agency, Cibinong, 16911, Indonesia

    Sri Jayanti & Caecilia Hapsari Ceriapuri Sukowati

  4. Department of Bioinformatics, Faculty of Health Technology, University of Megarezky, Makassar, 90234, Indonesia

    Ummu Syauqah Al Musyahadah

  5. Liver Cancer Unit, Fondazione Italiana Fegato ONLUS, AREA Science Park, 34149, Trieste, Italy

    Caecilia Hapsari Ceriapuri Sukowati

  6. Department of Clinical Microbiology, Hasanuddin University, Makassar, 90245, Indonesia

    Muhammad Nasrum Massi

  7. Microbiology Laboratory, Hasanuddin University Hospital, Makassar, 90245, Indonesia

    Muhammad Nasrum Massi

  8. Hasanuddin University Medical Research Center Laboratory, Faculty of Medicine, Hasanuddin University, Makassar, 90245, Indonesia

    Muhammad Nasrum Massi

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Contributions

Conceptualization, S.J.; F.S.T; N and M.N.M; writing—original draft preparation, S.J.; F.S.T; N; and U.S.A.M.; writing—review and editing, S.J.; F.S.T; N; U.S.A.M, C.H.C.S, and M.N.M; visualization, S.J. and U.S.A.M; All authors have read and agreed to the published version of the manuscript.

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Correspondence to Muhammad Nasrum Massi.

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Nurjannah, Jayanti, S., Tanoerahardjo, F.S. et al. Major Drug Resistance Mutations on Reverse Transcriptase Gene in Human Immunodeficiency Virus Type-1 in Indonesia: A Systematic Review. Curr HIV/AIDS Rep 21, 31–39 (2024). https://doi.org/10.1007/s11904-023-00687-5

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