DTG/3TC in Pregnancy — SCE Infectious Diseases MCQ

Instant feedback + full explanation. One question, done properly.

ModerateHIV MedicineDTG/3TC in PregnancySCE Infectious Diseases

A 30-year-old HIV-positive woman (CD4 580, VL <50 on ART) becomes pregnant. She is on DTG/3TC (Dovato — dual therapy). BHIVA pregnancy guidelines recommend which modification?

Educational content. Not a substitute for clinical judgement or local policy.

Reveal the answer and explanation

Correct answer: A — Switch from DTG/3TC dual therapy to triple ART (e.g. DTG/TAF/FTC or DTG/TDF/FTC) for the duration of pregnancy

BHIVA 2025 pregnancy guidelines recommend against using DTG/3TC dual therapy during pregnancy. The rationale is the reduced margin for error with only two active agents — if adherence lapses or drug levels fluctuate (common in pregnancy due to PK changes), the risk of viral breakthrough and vertical transmission is higher with dual vs triple therapy. The recommendation is to switch to triple ART (DTG plus two NRTIs, typically TDF/FTC or TAF/FTC) for the duration of pregnancy, reverting to DTG/3TC postpartum if desired.

Reference: BHIVA 2025 – HIV in pregnancy guidelines