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Antimalarial-ART Interactions — SCE Infectious Diseases MCQ

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HardTravel Medicine & VaccinationAntimalarial-ART InteractionsSCE Infectious Diseases

A person with well-controlled HIV takes dolutegravir/tenofovir alafenamide/emtricitabine and needs malaria chemoprophylaxis. What is the correct prescribing approach?

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Correct answer: CSelect prophylaxis by destination, resistance, comorbidity and verified interaction checking rather than assuming all standard options interact with dolutegravir with review

The best answer is “Select prophylaxis by destination, resistance, comorbidity and verified interaction checking rather than assuming all standard options interact with dolutegravir with review”. Contemporary ART often permits several standard malaria-prevention options, but the exact regimen requires destination-specific risk and an interaction resource. “Avoid every antimalarial because integrase inhibitors are absolute contraindications” does not match the decisive clinical feature or cited guidance. “Use mefloquine because it predictably lowers dolutegravir by 80%” does not match the decisive clinical feature or cited guidance. “Avoid atovaquone–proguanil because it is universally contraindicated with tenofovir alafenamide” does not match the decisive clinical feature or cited guidance. “Use chloroquine for every destination because it has no resistance” does not match the decisive clinical feature or cited guidance.

Reference: NaTHNaC HIV and travel guidance: https://travelhealthpro.org.uk/factsheet/16/hiv-and-aids