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Background ― Antiretroviral (ARV) therapy has successfully reduced the transmission, morbidity, and mortality of Human immunodeficiency virus 1 (HIV-1) infection, but the appearance of drug resistance mutations (DRMs) is an obstacle to successful HIV management. DRMs against nucleoside reverse transcriptase inhibitors (NRTIs) and non-nucleoside reverse transcriptase inhibitors (NNRTIs) have never been analyzed and reported in HIV-1 patients in Padang (West Sumatra, Indonesia). Objective ― This study aimed to identify NRTIand NNRTI-DRMs from HIV-1 proviral deoxyribonucleic acid (DNA) in HIV-infected patients who had received ARV therapy for >12 months at the Dr. M. Djamil General Hospital in Padang. Material and Methods ― We isolated HIV-1 proviral DNA from blood samples from 105 HIV-1 patients who had undergone first-line ARV therapy for >12 months. Isolates were amplified via a nested PCR technique using two primer-specific types of reverse transcriptase (RT). The amplicon was electrophoresed on 0.8% agarose gel and then sequenced. Analysis of DRMs in the HIV-1 RT genes was based on the Standford HIV database. Results ― The 17 isolates from 105 ARV-treated patients, eight RT genes were successfully sequenced, and DRM of RT inhibitors was found in one of the isolates (12.5%). The Stanford HIV database analysis detected three new DRMs at the 184th, 215th and 190th codon positions, causing three mutations: M184L and T215N (NRTI-DRMs) with low-level resistance to zidovudine, and G190D (NNRTI-DRM). Conclusion ― We concluded that the new DRMs found in Padang, West Sumatra indicates the importance of genotypic resistance testing and the periodic evaluation of the effectiveness of ARV drugs currently in use.

russian open medical journal

New drug resistance mutations of reverse transcriptase Human immunodeficiency virus type-1 gene in first-line antiretroviral-infected patients in West Sumatra, Indonesia