THE DEMOGRAPHIC PROFILE OF HIV-1 DRUG RESISTANCE PROTEASE/ REVERSE TRANSCRIPTASE (PR/RT) CASES IN MALAYSIA FROM 2020-2022

Abstract

Intro: Human immunodeficiency virus (HIV) is the etiologic agent of Acquired Immunodeficiency Syndrome (AIDS) which has been the biggest threat to mankind over the last three decades. There are two major types of HIV, which HIV-1is the most widespread type worldwide. Antiretroviral therapy (ART) has shown to reduce HIV-1 mortality and incidence globally. However, increased use of ART has been accompanied by the emergence of HIV drug resistance (HIV DR). Thus this might jeopardise the long term success of ART as the levels of HIV DR have steadily increased in recent years. Methods: The study is conducted on plasma samples from HIV-1 positive patients on ART with viral load 1000 copies/mL and above. HIV DR testing is performed by genotyping plasma virus using Sanger population sequencing. Then it is analysed with reference to Stanford HIV Drug Resistance Database. Patients’ forms are screened for clinical profile and demographic distribution. Findings: A total of 217 cases of HIV DR were detected in the year 2020, 508 cases in 2021 and 232 cases in 2022 (till July 2022). Majority of the cases 64.6% are from adult age group (30-59 years old) followed by age group 13-29 years old with 27.8% whilst the least is from the paediatric (59 years old), 1.8% and 1.5%. 65.4% of the cases were Malay, 13.5% were Chinese, 12.5% were Indian and 8.6% were other races. Geographically, HIV DR is seen most in Selangor (23.2%), followed by Perak (11.7%) then Johor (10.5%). The least number of cases is seen in Labuan (0.2%). Conclusion: Data from the study shows that there is an increase in HIV-1 DR cases in Malaysia. This trend is also observed globally, hence more proactive action from all bodies involved is needed to combat HIV-1 DR. This is to ensure the continued success of ART.