PPI Safe with DTG — SCE Infectious Diseases MCQ

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EasyHIV MedicinePPI Safe with DTGSCE Infectious Diseases

A 35-year-old man with HIV (CD4 480, VL <50 on DTG/TAF/FTC) is prescribed a proton pump inhibitor (Omeprazole 20 mg) by his GP for GORD. His ART is DTG-based, NOT Rilpivirine-based. Is this interaction clinically significant?

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Correct answer: E — No clinically significant interaction between PPIs and DTG/TAF/FTC — PPIs are safe with INSTI-based ART (unlike Rilpivirine where PPIs are contraindicated)

PPIs interact significantly with Rilpivirine (reducing absorption by ~40% — contraindicated), but have NO clinically significant interaction with DTG, BIC, TAF, or FTC. The Liverpool Drug Interactions database confirms green (no interaction) for Omeprazole with DTG-based regimens. This is a common query in clinical practice and an important reassurance point. The key teaching: PPI interactions are specific to Rilpivirine-containing ART, not a class effect of all ART.

Reference: Liverpool Drug Interactions 2024; BHIVA 2025 – ART; BNF 2024