Prevalence of HIV infection and resistance mutations in patients hospitalized for febrile illness in Indonesia

Tuti P. Merati, Muhammad Karyana, Emiliana Tjitra, Herman Kosasih, Abu T. Aman, Bachti Alisjahbana, Dewi Lokida, Dona Arlinda, Frank Maldarelli, Aaron Neal, Mansyur Arif, Muhammad Hussein Gasem, Nurhayati Lukman, Pratiwi Sudarmono, Chuen Yen Lau, Usman Hadi, Vivi Lisdawati, Wahyu Nawang Wulan, H. Clifford Lane, Sophia Siddiqui

Research output: Contribution to journalArticlepeer-review

5 Citations (Scopus)

Abstract

HIV prevalence in Indonesia is increasing, and only 64% of infected individuals know their status. In a prospective cohort of 1,453 hospitalized patients with unexplained fever, 46 (3.2%) had HIV, including 15 (1.1%) patients without a prior HIV diagnosis. Among 31 subjects previously known to have HIV, 21 (68%) had been receiving combination antiretroviral therapy (cART) at the time of enrollment. Of 39 HIV cases with HIV RNA levels $ 100 copies/mL, sequencing for genotype analysis and resistance testing was successful in 30 (77%) subjects. The most common HIV subtypes were AE (90%) and B (10%). Five (16.7%) subjects had resistance mutations to nucleoside and non-nucleoside reverse transcriptase inhibitors, and all of them were on cART. No evidence of transmitted drug resistance was found in newly diagnosed individuals. Hospital-based screening may be an efficient method to expand HIV testing and identify a significant number of new cases. Access to care, close monitoring, expansion of anti-retroviral options, and ensuring availability of CD4 determinations, viral load testing, and genotyping are crucial to control of the epidemic in Indonesia.

Original languageEnglish
Pages (from-to)960-965
Number of pages6
JournalAmerican Journal of Tropical Medicine and Hygiene
Volume105
Issue number4
DOIs
Publication statusPublished - Oct 2021

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