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Zoster in Well-Controlled HIV — SCE Infectious Diseases MCQ

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HardHIV MedicineZoster in Well-Controlled HIVSCE Infectious Diseases

A CMV-seropositive allogeneic stem-cell transplant recipient starts letermovir prophylaxis while receiving ciclosporin. Which oral letermovir dose is specified in the UK SmPC?

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

Reveal the answer and explanation

Correct answer: B — 240 mg once daily while ciclosporin is co-administered

Explanation lettering: B = shown as A · C = shown as B · E = shown as C · A = shown as E

C is correct. Standard adult letermovir prophylaxis is 480 mg once daily, but ciclosporin increases letermovir exposure and the dose is reduced to 240 mg once daily for the duration of co-administration. The adjustment is not 120 mg, and the medicine is not divided twice daily. This is a prophylaxis dose decision; emerging DNAaemia still requires a defined pre-emptive or treatment pathway rather than simply escalating letermovir empirically.

Reference: Prevymis 240 mg SmPC: https://www.medicines.org.uk/emc/product/11798/smpc