HIV Monitoring Frequency — SCE Infectious Diseases MCQ

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EasyHIV MedicineHIV Monitoring FrequencySCE Infectious Diseases

A 34-year-old man with HIV (CD4 580, VL <50 on DTG/TAF/FTC for 4 years) asks whether he still needs regular viral load monitoring given years of suppression. What does BHIVA 2025 recommend?

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Correct answer: C — Viral load monitoring can be reduced to every 4–6 months in stable patients on suppressive ART

BHIVA 2025 does not support stopping HIV viral load monitoring after prolonged suppression. In a stable, adherent patient established on suppressive ART with CD4 recovery and no current concerns, HIV RNA monitoring can be de-intensified rather than performed monthly or weekly: the appropriate option is ongoing viral load testing every 4–6 months. This maintains surveillance for virological rebound, adherence problems, drug interactions or treatment failure. Annual monitoring for all stable patients and complete cessation of monitoring are not recommended.

Reference: British HIV Association (BHIVA). BHIVA guidelines on antiretroviral treatment for adults living with HIV-1: 2025 interim update. https://www.bhiva.org/wp-content/uploads/2025/10/BHIVA-guidelines-on-antiretroviral-treatment-for-adults-living-with-HIV-1-2025-interim-update.pdf