Profile of antiretroviral resistance in HIV/AIDS pat ients in Dr. Soetomo General Academic Hospital Surabaya

Background: World HIV/AIDS prevalences reach to 36,9 million patient. Most patient located
in Africa as much as 24,7 million. Meanwhile in Asia, 4,8 million people recorded suffered from
HIV/AIDS. The first time HIV/AIDS was reported in Indonesia in 1987. The prevalence of HIV/
AIDS in Indonesia since it first discovered until 2016 was spread in 80% districs/cities from all
provinces in Indonesia. Dr. Soetomo general hospital is a referral hospital in the eastern part of
Indonesia. It has HIV care unit which many HIV/AIDS patients were treated with antiretroviral.
However, the data of profile of antiretroviral resistance is still limited.
Objective: This study aimed to identify the profile of antiretroviral resistance in patients
treated with antiretroviral in Dr. Soetomo hospital in Surabaya.
Methods: This study used descriptive retrospective design. The data of antiretroviral resistance was obtained from treated patients by using medical record. The examined population was
all patient diagnosed with HIV/AIDS in Dr. Soetomo Hospital Surabaya.
Results: Combination of Lamivudine, Zidovudine and Nevirapine of the first line antiretroviral was
most often used (70.6%) to treat the patients. The highest drug resistance was found in Nevirapine and
Efavirenz (members of Non-nucleoside reverce transcriptase inhibitors) (58.8%, respectively) with the
associated mutation patterns of HIV polymerase included Y181C, V108I, V106I, G190GA (~ Nevirapine
resistance) and Y181C, V108I, V106I (~ Efavirenz resistance); while the most resistant members of nucleoside reverce transcriptase inhibitors were Lamivudine and Emtricitabine (23.5%, respectively) (M184V and K65R), followed by Tenofovir (17.6%) (K65R) and Zidovudine (5.9%) (K219QE).
Conclusion: Most patients showed high resistance to Nevirapine and Efavirenz in non-nucleoside reverce transcriptase inhibitors group, followed by Lamivudine and Emtricitabine in nucleoside reverce transcriptase inhibitors group.