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"ABSTRACTBackground: the global scale-p of antiretroviral therapy (ART) is the primary factor contributing to the decline in deaths from acquired immune deficiency syndrome (AIDS)-related illnesses. However, the emergence of transmitted drug resistance (TDR) compromises the effects of ART in treatment-naive individuals, which may hinder treatment success. The present study aimed to identify the presence of TDR among treatment-naive individuals in Buleleng, Bali, which is currently ranked sixth among Indonesian provinces with the highest cumulative human immunodeficiency virus type 1 (HIV-1) infection cases. Methods: thirty-nine ART-naive individuals in Buleleng Regency General Hospital were enrolled in the present study. Blood samples from participants were subjected to a genotypic analysis. Results: 28 protease (PR) and 30 reverse transcriptase (RT) genes were successfully amplified and sequenced from 37 samples. HIV-1 subtyping revealed CRF01_AE as the dominant circulating recombinant form in the region. No TDR for PR inhibitors was detected; however, TDR for RT inhibitors was identified in five out of 30 samples (16.7%). Conclusion: these results indicate the emergence of TDR among ART-naive individuals in Buleleng, Bali. This issue warrants serious consideration because TDR may hamper treatment success and reduce ART efficacy among newly diagnosed individuals. Continuous surveillance with a larger sample size is necessary to monitor TDR among ART-naive individuals."

"Background: human immunodeficiency virus (HIV) infection and acquired immune deficiency syndrome (AIDS) cause serious health problems and affect the Indonesian economy. Papua province has the highest prevalence of HIV infection in the country; however, epidemiological data are limited. Therefore, in order to reveal the current situation of HIV/AIDS in Papua province, sero and molecular epidemiological studies of HIV were conducted. Methods: serological tests were conducted on 157 healthy individuals from the general population residing in Paniai, Papua. In addition, a molecular epidemiological study was then conducted on HIV type 1 (HIV 1) genes derived from infected individuals. Peripheral blood samples from HIV 1 positive individuals and 15 additionally enrolled, previously confirmed HIV 1 positive individuals were subjected to a genotypic analysis. Results: serological tests revealed that 2 out of 157 (1.27%) healthy individuals were HIV positive. In addition, HIV 1 subtyping revealed that subtype B and CRF01_AE were the major subtype and circulating recombinant form (CRF) of HIV 1 prevalent in the region, while subtype A1 and a recombinant form including viral gene fragments of CRF01_AE and subtype B was also detected. In addition, HIV drug resistance-associated major mutations were detected in the reverse transcriptase gene derived from infected individual on antiretroviral therapy. Conclusion: these results provide important information for clearer understanding on the current situation of HIV/AIDS in Papua province in Indonesia.

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Latar belakang: infeksi human immunodeficiency virus (HIV) dan acquired immune deficiency syndrome(AIDS) merupakan masalah kesehatan masyarakat yang sangat serius dan mempengaruhi perekonomian di Indonesia. Provinsi Papua memiliki prevalensi HIV tertinggi di negeri ini. Namun data tentang epidemiologi HIV sangat terbatas. Oleh karena itu, dilakukan studi sero-epidemiologi HIV pada orang sehat yang berada di daerah Paniai, Papua.

Metode: pemeriksaan serologi dilakukan pada 157 orang sehat dari populasi umum di Paniai, Papua. Selain itu, studi epidemiologi molekuler kemuian dilakukan pada gen HIV tipe 1 (HIV-1) dari individu yang ditemukan terinfeksi. Analisis genotipe dilakukan terhadap sampel darah perifer dari individu HIV-1-positif dan 15 sampel tambahan dari individu yang sebelumnya telah dikonfirmasi positif HIV-1.

Hasil:pemeriksaan serologis menunjukkan bahwa 2 dari 157 orang sehat (1,27%) dinyatakan positif HIV. Pemeriksaan genotip pada sampel HIV-1 menunjukkan bahwa subtipe B dan circulating recombinant form (CRF) CRF01_AE merupakan subtipe terbanyak dan CRF HIV-1 yang banyak ditemukan di wilayah tersebut, sementara subtipe A1 dan rekombinan antara CRF01_AE dan subtipe B juga ditemukan pada penelitian ini. Selain itu, pada pasien HIV yang sudah mendapatkan terapi ARV juga ditemukan mutasi mayor pada daerah reverse transcriptase.

Kesimpulan: hasil penelitian ini dapat memberikan informasi penting untuk memahami situasi perkembangan HIV/AIDS saat ini di provinsi Papua di Indonesia"