Gambaran Kasus Mutasi Terkait Resistensi Antiretroviral pada orang dengan HIV-AIDS (ODHA) di Tiga Kabupaten/Kota di Provinsi Papua

Hotma Hutapea

doi:10.22435/bpk.v46i3.902

Hotma Hutapea

DOI: https://doi.org/10.22435/bpk.v46i3.902

Keywords: ARV

Abstract

Antiretroviral (ARV) therapy has been found effective to decrease HIV-1 infected cases, however increase the resistances due to nucleotide mutation. The mutation causes virus to be resistant to ARV, making the therapy is no longer effective. The ARV therapy District Nabire, Jayapura, and Jayawijaya was Reverse Transcriptase Inhibitor (RTI). The goal of this study was to obtain the data of mutation associated to viral resistance to ARV RTI and protease inhibitor group. Plasma samples were obtained from 252 subjects purposively in HIV/AIDS population from corresponding Care, Support, and Therapy clinic. The genotyping, measurement of CD4 and viral load were performed to all samples. DNA analysis was performed by genotyping method. Among 252 samples, 89 samples (35.32%) had CD4 count <350 sel/ul. Twenty three samples (8.73%) had viral load >10.000 copies/mL. There were 15 (5,95%) samples were identified as mutant related to RTI resistance, and none for protease. The most frequent mutation motive was M184V/I, 12 samples (80,00%). This data provided important information about the continuous need of ARV therapy monitoring to suppress transmission drug resistance.

Abstrak

Penemuan antiretroviral (ARV) secara signifikan telah menjadi bagian penting dalam penanggulangan HIV/AIDS. Terapi ARV dilakukan untuk menurunkan kasus HIV-1, namun dapat menyebabkan resistensi virus terhadap ARV tersebut. Data prevalensi HIV-1 resisten ARV pada Orang Dengan HIV/AIDS (ODHA) di Papua, khususnya Kabupaten Nabire, Kab./Kota Jayapura, dan Kab. Jayawijaya belum tersedia. Tujuan penelitian ini adalah untuk mendapatkan data prevalensi mutasi terkait resistensi virus terhadap ARV golongan penghambat rtase dan protease. Sebanyak 84 responden yang sudah diterapi minimal 6 bulan diambil secara purposive dari setiap lokasi penelitian. Genotyping, pemeriksaan nilai CD4 dan viral load dilakukan terhadap semua sampel. Analisis DNA dilakukan dengan metode genotyping. Dari 252 sampel, sebanyak 89 responden (35,32%) memiliki nilai CD4 <350 sel/ul darah. Sebanyak 23 responden (8,73%) memiliki nilai viral load >10.000 salinan/mL. Sebanyak 15 sampel (5,95%) teridentifikasi mengalami mutasi pada DNA target ARV golongan penghambat rtase, dan tidak ditemukan mutasi terkait resistensi pada gen protease. Motif mutasi yang paling banyak adalah M184V/I, yaitu sebanyak 12 sampel (80,00%). Penelitian ini mengindikasikan bahwa pemantauan terapi ARV secara berkesinambungan tetap diperlukan untuk menekan penulan HIV resisten ARV.

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