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The advent of two-drug combination antiretroviral therapy (cART) challenged the dogma of three-drug regimens. Now, in the EARLY-SIMPLIFIED trial, investigators in Switzerland describe successful treatment with dolutegravir (DTG) monotherapy of a selected subset of 101 persons with HIV. Participants who started cART within 180 days of their primary HIV infection and who had ≥48 weeks of HIV RNA levels <50 copies/mL were randomized 1:2 to continue cART or switch to DTG monotherapy. Patients were followed for 192 weeks; after 96 weeks they were allowed to switch study treatments.
At 96 weeks, DTG monotherapy was noninferior to cART and no virologic failures occurred in the per-protocol analysis at 48, 96, 144, or 192 weeks. In addition, there w…