Introduction: The effectiveness of antiretroviral therapy (ART) in treating HIV is in-fluenced by the clinical response of patients, which, in turn, impacts the development of drug resistance. This study aimed to assess the correlation between clinical treatment response and resistance to first-line reverse transcriptase inhibitors in HIV patients receiving treatment for ≤12 and >12 months in South Sulawesi, a province in Indonesia.

Methods: In this cross-sectional study, 36 people living with HIV (PLHIV) experiencing viro-logical failure (VF) were sampled from HIV services in the province from August 2022 to January 2023. HIV-1 viral RNAs were extracted, sequenced, and analyzed for drug sensitivity and re-sistance classification using the Stanford University HIV Drug Resistance Database (HIVdb) ac-cording to World Health Organization (WHO) recommendations, determining resistance levels and HIV subtypes. Phylogenetic analysis of PR-RT sequences (~1200 base pairs) was performed using the Muscle program and MEGA11 software, utilizing the neighbor-joining method with the Kimura two-parameter model.

Results: Genotyping of plasma samples revealed that a significant proportion of patients exhib-ited mutations associated with resistance to both nucleoside reverse transcriptase inhibitors (NRTIs) and non-NRTIs (NNRTIs) (48.6% and 51.4%, respectively). Clinical response indica-tors, such as initial body mass index and occurrence of opportunistic infections, were found to correlate with specific drug resistance, highlighting the importance of monitoring treatment re-sponse. Moreover, virologic response showed strong associations with resistance to specific drugs, suggesting the need for tailored therapeutic approaches. Patient behaviors related to trans-mission risk factors were also found to be linked to resistance levels, underscoring the multifac-torial nature of resistance development.

Conclusion: Overall, this study underscores the importance of considering treatment response in managing HIV and suggests implications for optimizing therapy regimens to mitigate resistance emergence.

Keywords: HIV drug resistance; Treatment response; reverse transcriptase inhibitors..

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简介： 抗逆转录病毒疗法（ART）在治疗HIV方面的有效性受患者临床反应的影响，而这种影响又会影响药物耐药性的发展。本研究旨在评估南苏拉威西省接受≤12个月和>12个月一线逆转录酶抑制剂治疗的HIV患者的临床治疗反应与药物耐药性之间的相关性。

方法： 在这项横断面研究中，36名经历病毒学失败（VF）的人类免疫缺陷病毒（HIV）感染者从2022年8月至2023年1月被纳入南苏拉威西省的HIV服务项目。使用斯坦福大学人类免疫缺陷病毒耐药性数据库（HIVdb）根据世界卫生组织（WHO）的推荐，提取、测序并分析了HIV-1病毒RNA以确定药物敏感性和抗药性的分类，并确定耐药水平和HIV亚型。利用Muscle程序和MEGA11软件使用Kimura双参数模型和邻接法对PR-RT序列（约1200个碱基对）进行了系统发育分析。

结果： 血浆样本的基因分型显示，患者中有相当一部分人表现出与核苷类似物逆转录酶抑制剂（NRTIs）和非核苷类逆转录酶抑制剂（NNRTIs）耐药性相关的突变（分别为48.6% 和51.4%）。临床反应指标如初始体质指数和机会性感染的发生频率，被发现与特定药物的抗药性有关联，强调了监测治疗反应的重要性。此外，病毒学反应显示出与特定药物耐药性的强烈关联，表明需要量身定制的治疗方法。患者的传播风险因素相关行为也被发现与耐药水平有关，突出了耐药发展多因性。

结论： 总体而言，本研究强调了在管理HIV时考虑治疗反应的重要性，并建议对优化疗法方案以减少耐药性出现具有重要意义的改进措施。

关键词： 人类免疫缺陷病毒药物耐药性；治疗反应；逆转录酶抑制剂..

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