Sorry, the best answer is A. LEN use in pregnancy is supported by several agencies or guidelines. In the PURPOSE1 trial, lenacapavir was found to be present in breastmilk (median milk-to-plasma ratio: 0.63 [n=8 matched pairs]); LEN exposure in infant plasma was low (median breastfed-infant-to-mother plasma ratio: 0.05 [n=11 matched pairs]). Also in the trial, participants who became pregnant could opt to re-consent and remain on randomized study drug or receive open-label TDF/FTC. Predicted lenacapavir exposure was not statistically significantly different by pregnancy trimester or postpartum status compared with non-pregnant/lactating participants.
References: Bekker, et al. NEJM. 2024;391:1179. and Bekker, et al, 12th IAS Conference on HIV Science (IAS 2025); July 13-17, 2025; Kigali, Rwanda.