Background: The emergence of transmitted drug resistance (TDR) compromises the effect of antiretroviral therapy\n(ART), resulting in treatment failure of human immunodeficiency virus (HIV) disease. Although more than a decade\nhas passed since ART was introduced into Indonesia, information on TDR is limited. Here, a genotypic study of TDR\namong ART-na�¯ve individuals was conducted in Surabaya, Indonesia.\nMethod: HIV-1 seropositive participants were recruited from the communities of commercial sex workers and\nintravenous drug users as well as from the university teaching hospital in Surabaya. Protease (PR) and reverse\ntranscriptase (RT) genes were sequenced in order to conduct HIV-1 subtyping and phylogenetic analysis and to\ndetect TDR. TDR was defined as the presence of at least one surveillance drug resistance mutation on the WHO list\nor major drug resistance mutations in the International AIDS Society-USA panel.\nResult: Fifty two and 47 of the PR and RT genes, respectively, were successfully sequenced in the 58 samples. HIV-1\nsubtyping revealed that 86.3% (50/58) of the sequenced samples were classified as CRF01_AE, 8.6% as subtype B,\n3.4% as B/CRF01_AE, and 1.7% as A/G/CRF01_AE. TDR of PR inhibitors was not detected in this study. In contrast,\nTDR of RT inhibitors was detected in 4.3% (2/47) of samples. In addition, minor drug resistance mutations were\ndetected in 98.1% (51/52) and 12.8% (6/47) of PR and RT genes, respectively.\nConclusion: This study clarified the predominance of the CRF01_AE strain in Surabaya, Indonesia. The prevalence of\nTDR was below 5%, indicating that the currently available first-line regimen is still effective in Surabaya. However,\nthe prevalence might be underestimated since we detected only major population of HIV-1 in individuals.\nTherefore, continuous surveillance is required in order to detect the emergence of TDR in the early phase.
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