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HIV — SCE Infectious Diseases MCQ

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HardHIV MedicineHIVSCE Infectious Diseases

A 34-year-old woman with HIV presents to clinic. Her resistance test from diagnosis 4 years ago shows M184V mutation. She is currently virally suppressed on Tenofovir DF/Emtricitabine/Dolutegravir. She requests simplification to a two-drug regimen. What is the most appropriate recommendation?

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Correct answer: B — Continue current triple regimen

Dolutegravir/Lamivudine dual therapy is contraindicated in patients with documented M184V resistance, as this confers high-level resistance to both Lamivudine and Emtricitabine and leaves the regimen essentially as Dolutegravir monotherapy, risking integrase resistance. CAB/RPV-LA requires confirmed viral suppression and shares the concern about archived NNRTI resistance. The safest option is to continue the current effective triple regimen.

Reference: BHIVA 2025 – Guidelines on antiretroviral treatment for adults living with HIV-1 (2025 interim update)