Wijting IEA, Rokx C, Zillikens MC, et al. - Given the possibility of metabolic toxicities in relation to combination antiretroviral therapy (cART), researchers examined the influence of cART simplification to dual or monotherapies on metabolic markers. In the randomized clinical DOlutegravir MONOtherapy for HIV trial, which included HIV-positive participants, the metabolic effects of cART simplification to dolutegravir (DTG) monotherapy was determined. DTG monotherapy was initiated in 95 patients, including 80 discontinuing tenofovir disoproxil fumarate (TDF). Simplification of TDF-containing cART to DTG monotherapy led to amelioration of lumbar spine BMD and proteinuria with neutral effect on lipids and inflammation markers. Although the investigators recommended not using DTG monotherapy in routine care and emphasized the necessity for further elucidation of its role in strictly selected patients with primary HIV infection, these observations remain relevant concerning DTG-based dual therapy without TDF.