By: Eka Windari R., Nur Latifah Hanum, Restu Amalia Mukti

Following the Site Closeout Visit conducted on February 19, 2025, the InVITE study activities involving the study teams and subjects at each study site have been officially completed. Currently, the remaining activity is the preparation of the Final Report, which will include comprehensive information covering the entire activities of the InVITE study—from the beginning to its completion.

The Final Report will contain details on the Background, Study Design, Study Workflow, Ethics Approval History, Monitoring Activities, Study Specimen Accountability, Subject Status, Study Results with corresponding discussions (including infor-mation on any publications in international jour-nals based on the study results), Subject Safety Reports, a List of Protocol Deviations, and the Conclusion. The Final Report’s completion target is by the end of April 2025. It will be submitted in May 2025 as a supporting document for the study closure notification to the hospital directors at each study site and the RSUD Kabupaten Tangerang Ethics Committee.

In addition, following the successful shipment of participants’ sera from Visits 1–3 and Symptomatic Visits, the planned shipment of the remaining In-VITE specimens is still in progress. This shipment includes SARS-CoV-2 RNA extracted from mid-turbinate swab specimens collected in Universal Transfer Media (UTM) from Symptomatic Visits and serum specimens from extension Visits 4 and 5. The Material Transfer Agreement (MTA) for this shipment is handled separately from the previous shipment, as Visits 4–5 and some Symptomatic Visits were still ongoing at the time of the initial MTA process. Additionally, the shipment plan was revised due to regulations concerning potential poliovirus in biological specimens—from transporting mid-turbinate swabs in UTM to shipping extracted RNA instead. A new MTA Committee and updated regulations have since been established, including a streamlined review process through the official MTA submission website. However, as the website is currently under maintenance, the required MTA documents—including the draft agreement and appendices—were submitted via email on March 20, 2025. The submission is currently under review by the MTA Committee, and the study team is maintaining active communication with the MTA Secretariat. The team hopes to receive approval soon, as the laboratory testing at the Central Laboratory must be completed by the end of 2025, requiring the shipment to proceed as scheduled in June 2025.

By: Eka Windari R., Nur Latifah Hanum, Restu Amalia Mukti

As of December 22, 2023, a formal notification was submitted to the Health Research Ethics Committee of the Faculty of Medicine, Universitas Indonesia–Cipto Mangunkusumo Hospital (KEPK FKUI–RSCM), confirming that all subject visits for the INA-PROACTIVE study had been completed across participating sites. Comprehensive documentation of the study, from initiation to completion, has been compiled in a Final Report, which was submitted via the KEPK FKUI–RSCM website on March 25, 2025, as part of the official study closure process.

With a robust dataset comprising 4,336 people living with HIV (PLWH) enrolled from 19 hospitals across Indonesia, the INA-PROACTIVE study holds strong potential to generate beneficial insights that can improve HIV care and policy in the country. Several impactful dissemination activities were also highlighted in the Final Report, demonstrating that the study has meaningfully built upon the study team’s hard work and the subjects’ valuable contributions. Two members of the study team—Neneng Aini (Clinical Research Associate) and Wahyu Nawang Wulan (Laboratory Technologist)—utilized the study data for their academic research at Universitas Indonesia. Neneng successfully earned her Master of Public Health degree with a thesis titled “Factors Associated with Antiretroviral Therapy Adherence in PLWH in Jakarta”. Nawang also graduated with a doctoral degree in Biomedical Science, defending her dissertation entitled “Establishing a Method for Identification of Recent HIV Infection and Genotypic Characterization of HIV-1 in Newly Diagnosed Individuals in Indonesia”.

When the INA-PROACTIVE study was still ongoing, preliminary findings were presented at several international conferences. Dona Arlinda (Protocol Principal Investigator) shared a poster titled “HIV Viral Suppression Rate at Enrolment, Status at One Year, and Associated Factors to Non-Suppression Among Outpatient Adults at 19 Hospitals in Indo-nesia” at the International Society for Infectious Diseases (ISID) Congress in Kuala Lumpur, Malay-sia (November 17–20, 2022). Aly Diana (Manuscript Writing and Publication Specialist) presented two posters— “A Prospective Observational Cohort Study of HIV Infection in Indonesia: Baseline Characteristics and One-Year Mortality” and “Late Presentation Among PLWH at 19 Refer-ral Hospitals in Indonesia: Trends and Characteris-tics from the INA-PROACTIVE Cohort”—at the 72nd American Society of Tropical Medicine & Hygiene (ASTMH) Annual Meeting in Chicago, Illinois (October 18–22, 2023). Additionally, Na-wang delivered a recorded presentation titled ‘Development of a Multiassay Algorithm (MAA) to Identify Recent HIV Infection in Newly Diagnosed Individuals in Indonesia’ at the 36th Annual Meeting of the Japanese Society for AIDS Research, held in Hamamatsu, Japan (November 18–20, 2022). She also presented ‘Transmission Dynamics of HIV-1 CRF01_AE in Indonesia’ at the 31st International Dynamics & Evolution of Human Viruses Meeting in Squamish, Canada (June 20–22, 2024).

Following the completion of study database cleaning and locking, the study team enthusiastically proceeded with data analysis and manuscript development, resulting in publications in high-impact journals. Nawang’s analysis of the MAA was refined and published in iScience on October 20, 2023. The main manuscript, which serves as the foundation for future publications, titled “A Prospective Observational Cohort Study of HIV Infection in Indonesia: Baseline Characteristics and One-Year Mortality”, was published in BMC Infectious Diseases on January 20, 2025. With the Final Report now submitted, data analysis and manuscript preparation using INA-PROACTIVE study data remain ongoing. We hope this largest cohort study of PLWH in Indonesia will enhance and support national HIV care and inspire further research across the country.

Figure 1. Documentation During Presentation Using INA-PROACTIVE Data