NI LUH AYU MEGASARI, NIM011617017347 (2019) IDENTIFIKASI MUTASI TERKAIT DRUG RESISTANCE GEN PROTEASE DAN REVERSE TRANSCRIPTASE HIV-1 PADA PASIEN TREATMENT NAÏVE DAN TREATED DI KABUPATEN BULELENG, BALI. Disertasi thesis, Universitas Airlangga.

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Abstract

Objective: To identify any drug resistance related mutation in the protease (PR) and reverse transcriptase (RT) gene of HIV-1 among treatment naive and treated patients in Buleleng Regency, Bali; and analyse its correlation to viral load. Materials and Methods: A total of 102 whole blood samples were collected from 63 treated and 39 treatment-naive patients. RNA were subjected to viral load quantification using qRT-PCR, while PR and RT gene were amplified from proviral DNA using PCR. Successfully amplified products were then subjected to sequencing. Results: Minor drug resistance related mutations were found in the PR gene of all patients. 15.6% (5/30) treatment naive and 9.1% (4/44) treated patients conferred major mutations in the RT gene, whilst minor mutations were also identified in both groups. RT gene mutations including V90I, V179F, G190A, and K209Q have never been reported among treatment naive patients in Indonesia. Viral load was correlated to the presence of major mutation in the RT gene of treated patients (p<0.05). Subtyping revealed CRF01_AE (96,8%) as the predominant subtype circulating in Buleleng Regency. Other subtypes, including CRF02_AG and CRF01_AE/CRF02_AG recombination which identified in this study, were previously not reported among HIV-positive patients in Bali Province. Conclusion: Both major and minor drug resistance related mutations were identified in the RT gene of HIV-1 of both treatment naive and treated patients; however only minor mutations were identified in the PR gene. Viral load was correlated to the presence of major mutation in the RT gene of treated patients.

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