100+ Free DipHIV Practice Questions

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2026 Statistics

Key Facts: DipHIV Exam

120 Qs

Exam BO5s

Society of Apothecaries DipHIV Guide

180 min

Time Limit

Society of Apothecaries DipHIV Guide

£595

Exam Fee

Society of Apothecaries Fees 2026

Angoff

Standard Setting

Society of Apothecaries Board

BHIVA

Guideline Alignment

BHIVA / BASHH Guidelines

The DipHIV is a 3-hour, 120-question remote online BO5 examination assessing clinical competency across HIV therapeutics, opportunistic infections, comorbidities, PMTCT, and public health guidelines.

Sample DipHIV Practice Questions

Try these sample questions to test your DipHIV exam readiness. Each question includes a detailed explanation. Start the interactive quiz above for the full 100+ question experience with AI tutoring.

1A 34-year-old man recently diagnosed with HIV-1 infection is undergoing baseline evaluation prior to commencing antiretroviral therapy (ART). The clinical team is considering a regimen containing abacavir. Which genetic screening test must be confirmed negative prior to prescribing abacavir?

A.HLA-B*5701 allele screening

B.HLA-B*2701 allele screening

C.Glucose-6-phosphate dehydrogenase (G6PD) deficiency assay

D.Thiopurine S-methyltransferase (TPMT) activity assay

Explanation: HLA-B*5701 allele screening is mandatory prior to initiating abacavir because individuals carrying this allele have a high risk (approximately 50%) of developing a severe, potentially life-threatening immunologically mediated hypersensitivity reaction. Screening and avoiding abacavir in HLA-B*5701 positive patients virtually eliminates abacavir hypersensitivity reaction (AHR) in clinical practice.

2A 28-year-old woman starts first-line ART with co-formulated bictegravir/tenofovir alafenamide/emtricitabine (Biktarvy). What is the mechanism of action of bictegravir?

A.Inhibition of HIV-1 integrase strand transfer activity

B.Competitive inhibition of reverse transcriptase nucleotide binding

C.Non-competitive allosteric inhibition of reverse transcriptase

D.Inhibition of HIV-1 protease catalytic cleavage site

Explanation: Bictegravir is a second-generation integrase strand transfer inhibitor (INSTI). It selectively binds to the active site of the HIV integrase enzyme and blocks the strand transfer step of proviral DNA integration into the host cellular chromosome.

3A 52-year-old male with HIV-1 infection and baseline eGFR of 55 mL/min/1.73m2 and early osteopenia is being switched from tenofovir disoproxil fumarate (TDF) to tenofovir alafenamide (TAF). What pharmacokinetic characteristic of TAF accounts for its improved renal and bone safety profile compared to TDF?

A.TAF is more stable in plasma, delivering active drug intracellularly and resulting in 90% lower systemic plasma tenofovir exposure

B.TAF is cleared exclusively by hepatic metabolism with no renal excretion

C.TAF achieves higher plasma concentrations, which enhances renal tubular clearance

D.TAF does not require intracellular phosphorylation to form active tenofovir diphosphate

Explanation: TAF is a prodrug of tenofovir that remains stable in circulating plasma and undergoes intracellular cleavage by cathepsin A primarily within peripheral blood mononuclear cells (PBMCs) and target cells. Consequently, TAF delivers higher intracellular tenofovir diphosphate levels while reducing circulating plasma tenofovir levels by over 90% compared to TDF, markedly reducing proximal renal tubular toxicity and bone mineral density loss.

4A healthcare assistant sustains a deep needle-stick injury while drawing blood from an HIV-positive patient whose most recent viral load was 45,000 copies/mL. Which statement correctly reflects UK guidelines (BHIVA/BASHH) regarding Post-Exposure Prophylaxis (PEP)?

A.PEP should be initiated as soon as possible, ideally within 2 hours and no later than 72 hours post-exposure, for a duration of 28 days

B.PEP should be delayed until 14 days after exposure to allow antibody seroconversion testing

C.PEP consists of a 7-day course of zidovudine monotherapy

D.PEP is only indicated if the source patient has a viral load greater than 500,000 copies/mL

Explanation: UK national guidelines recommend initiating PEP as soon as possible after significant occupational exposure, ideally within 2 to 72 hours, for a total duration of 28 days using a recommended 3-drug regimen (typically TDF/FTC plus dolutegravir or raltegravir). Efficacy declines significantly when started beyond 72 hours.

5A 29-year-old cisgender man who has sex with men (MSM) presents for advice on HIV Pre-Exposure Prophylaxis (PrEP). He has episodic sexual exposures and requests event-driven (2-1-1) PrEP with oral TDF/FTC. How should this regimen be taken relative to sex?

A.Take 2 tablets 2-24 hours before sex, 1 tablet 24 hours after the first dose, and 1 tablet 48 hours after the first dose

B.Take 1 tablet daily starting 7 days before anticipated sexual activity

C.Take 2 tablets immediately after sex and 2 tablets 12 hours later

D.Take 1 tablet every 12 hours for 5 days following sexual exposure

Explanation: Event-driven (2-1-1 or 'on-demand') PrEP for MSM consists of a loading dose of 2 tablets of TDF/FTC taken 2 to 24 hours prior to sexual intercourse, followed by 1 tablet 24 hours after the loading dose, and 1 tablet 48 hours after the loading dose (continuing daily if sex continues until 48 hours after the last sexual act).

6A 31-year-old ART-naïve male is being evaluated for initiation of dual therapy with dolutegravir/lamivudine (Dovato). Which clinical finding represents an absolute contraindication to initiating this dual-drug regimen?

A.Chronic active Hepatitis B virus (HBV) co-infection

B.Baseline CD4 count of 350 cells/µL

C.Age greater than 30 years

D.Mild essential hypertension treated with amlodipine

Explanation: Dolutegravir/lamivudine (Dovato) is contraindicated in individuals with chronic active Hepatitis B co-infection because lamivudine monotherapy for HBV leads to rapid emergence of the HBV M204V/I resistance mutation. HBV co-infected patients require a regimen containing two HBV-active NRTIs (tenofovir [TDF or TAF] plus lamivudine or emtricitabine).

7A 44-year-old woman on dolutegravir/abacavir/lamivudine presents with a rising HIV-1 viral load from <50 copies/mL to 1,400 copies/mL over 3 months. Medication reconciliation reveals she recently began taking over-the-counter magnesium/aluminum hydroxide antacids twice daily for indigestion. What is the mechanism of this drug interaction?

A.Polyvalent cations chelate integrase inhibitors in the gastrointestinal tract, significantly reducing drug absorption and bio-availability

B.Antacids induce hepatic CYP3A4 metabolism, accelerating dolutegravir clearance

C.Magnesium raises gastric pH, which inhibits intracellular phosphorylation of lamivudine

D.Aluminum blocks renal tubular excretion of abacavir, leading to toxic metabolite accumulation

Explanation: Integrase strand transfer inhibitors (INSTIs) like dolutegravir, bictegravir, and raltegravir chelate with polyvalent metal cations (Mg2+, Al3+, Ca2+, Fe2+) in the gastrointestinal tract. This forms insoluble complexes that markedly impair INSTI absorption. INSTIs should be administered at least 2 hours before or 6 hours after polyvalent cation-containing antacids.

8A 38-year-old man with HIV-1 infection is diagnosed with smear-positive pulmonary tuberculosis and starts rifampicin, isoniazid, pyrazinamide, and ethambutol. He is currently on a dolutegravir-based ART regimen. How should his dolutegravir dosing be adjusted during anti-TB treatment?

A.Increase dolutegravir dose to 50 mg twice daily (BD)

B.Decrease dolutegravir dose to 25 mg once daily

C.Switch dolutegravir to efavirenz 800 mg daily

D.Maintain dolutegravir 50 mg once daily without adjustment

Explanation: Rifampicin is a potent inducer of hepatic UGT1A1 and CYP3A4 enzymes, which markedly lowers plasma concentrations of dolutegravir. To overcome enzyme induction, BHIVA guidelines recommend increasing the dose of dolutegravir to 50 mg twice daily (BD) while co-prescribed with rifampicin, continuing for 2 weeks after rifampicin discontinuation.

9A genotypic resistance report for a patient experiencing virological failure on a first-generation NRTI regimen identifies the M184V mutation in reverse transcriptase. What impact does the M184V mutation have on antiretroviral susceptibility?

A.Confers high-level resistance to lamivudine and emtricitabine, while hypersensitizing HIV-1 to tenofovir and reducing viral replicative capacity

B.Confers high-level resistance to tenofovir disoproxil fumarate and zidovudine, while maintaining full sensitivity to lamivudine

C.Confers broad cross-resistance across all integrase inhibitors including dolutegravir and bictegravir

D.Confers high-level resistance to all non-nucleoside reverse transcriptase inhibitors

Explanation: The M184V (or M184I) point mutation in HIV-1 reverse transcriptase causes high-level (>100-fold) resistance to lamivudine (3TC) and emtricitabine (FTC). Crucially, M184V also impairs viral replicative fitness (viral fitness deficit) and increases susceptibility (hypersensitization) to tenofovir (TDF/TAF) and zidovudine.

10A baseline resistance genotype in a newly diagnosed HIV-1 patient demonstrates the K103N mutation. Which antiretroviral drug class is primarily compromised by this single point mutation?

A.First-generation NNRTIs (efavirenz and nevirapine)

B.Second-generation INSTIs (dolutegravir and bictegravir)

C.Boosted Protease Inhibitors (darunavir and atazanavir)

D.Nucleoside Reverse Transcriptase Inhibitors (abacavir and tenofovir)

Explanation: The K103N mutation is the most common transmitted NNRTI resistance mutation. It causes high-level cross-resistance to first-generation NNRTIs, specifically efavirenz and nevirapine. Second-generation NNRTIs (such as doravirine or etravirine) or INSTI-based regimens remain effective options.

About the DipHIV Exam

The Diploma in HIV Medicine (DipHIV) is the gold-standard UK postgraduate qualification awarded by the Worshipful Society of Apothecaries in association with BHIVA and BASHH, certifying advanced expertise in clinical HIV management.

Assessment

120 BO5 questions across 4 blueprint domains (30% ART Pharmacology, 30% Opportunistic Infections, 25% Comorbidities & Special Populations, 15% Diagnosis & Public Health).

Time Limit

180 minutes

Passing Score

Angoff standard setting (~65-70%)

Exam Fee

£595 (Worshipful Society of Apothecaries (with BHIVA and BASHH))

DipHIV Exam Content Outline

30%

Antiretroviral Therapy (ART) and Clinical Pharmacology

First-line ART regimens, INSTIs, NNRTIs, PIs, NRTIs, resistance testing, drug-drug interactions, PEP, and PrEP.

30%

Opportunistic Infections and Co-infections

PCP, TB, CMV, Cryptococcus, Toxoplasmosis, Hepatitis B/C co-infection, IRIS, and fungal infections.

25%

Non-infectious Comorbidities and Special Populations

Cardiovascular risk, renal disease, bone health, pregnancy, PMTCT, paediatric HIV, and aging.

15%

HIV Diagnosis, Immunology, and Public Health

Viral load, CD4 count, primary HIV infection, testing guidelines, U=U, partner notification, and ethics.

How to Pass the DipHIV Exam

What You Need to Know

Passing score: Angoff standard setting (~65-70%)
Assessment: 120 BO5 questions across 4 blueprint domains (30% ART Pharmacology, 30% Opportunistic Infections, 25% Comorbidities & Special Populations, 15% Diagnosis & Public Health).
Time limit: 180 minutes
Exam fee: £595

Keys to Passing

Complete 500+ practice questions
Score 80%+ consistently before scheduling
Focus on highest-weighted sections
Use our AI tutor for tough concepts

DipHIV Study Tips from Top Performers

1Prioritise up-to-date BHIVA guidelines on ART initiation, drug interactions, pregnancy, and opportunistic infection management.

2Master ART pharmacology including INSTI resistance profiles, HLA-B*5701 testing, and renal safety differences between TDF and TAF.

3Understand the precise clinical timing of ART initiation in opportunistic infections like TB and Cryptococcal meningitis to prevent neuro-IRIS.

Frequently Asked Questions

What is the format of the UK Diploma in HIV Medicine (DipHIV) exam?

The examination consists of 120 Best of Five (BO5 / SBA) questions administered over a single 3-hour (180-minute) session via remote invigilation.

What is the pass mark for the DipHIV examination?

The pass mark is set for each diet using the modified Angoff method, typically falling between 65% and 70%.

Who is eligible to take the DipHIV exam?

Registered medical practitioners with clinical experience in HIV medicine, including trainees and consultants in Genitourinary Medicine (GUM), Infectious Diseases, General Internal Medicine, and Sexual Health.