{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,5,4]],"date-time":"2026-05-04T20:41:11Z","timestamp":1777927271868,"version":"3.51.4"},"reference-count":21,"publisher":"SAGE Publications","issue":"11","license":[{"start":{"date-parts":[[2019,8,20]],"date-time":"2019-08-20T00:00:00Z","timestamp":1566259200000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/journals.sagepub.com\/page\/policies\/text-and-data-mining-license"}],"funder":[{"DOI":"10.13039\/501100005797","name":"Vereniging Trustfonds Erasmus Universiteit Rotterdam","doi-asserted-by":"publisher","award":["97030.34\/15"],"award-info":[{"award-number":["97030.34\/15"]}],"id":[{"id":"10.13039\/501100005797","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["journals.sagepub.com"],"crossmark-restriction":true},"short-container-title":["Int J STD AIDS"],"published-print":{"date-parts":[[2019,10]]},"abstract":"<jats:p>Combination antiretroviral therapy (cART) can cause metabolic toxicities. How cART simplification to dual or monotherapies affects metabolic markers is unknown. We analyzed the metabolic effects of cART simplification to dolutegravir (DTG) monotherapy in the randomized clinical DOMONO (DOlutegravir MONOtherapy for HIV) trial including HIV-positive participants. Renal function, Framingham risk score (FRS), inflammation, and bone mineral density (BMD) with trabecular bone score (TBS) were measured during 48 weeks after simplification. The changes at 48 weeks by on-treatment analyses overall and for prior tenofovir disoproxil fumarate (TDF) exposure were analyzed separately, using Bonferroni corrected alpha (p\u2009=\u20090.00096). Ninety-five patients initiated DTG monotherapy, including 80 discontinuing TDF. At week 48, the switch to DTG monotherapy resulted in an expected \u22127.8\u00a0ml\/min estimated glomerular filtration decline. In patients on prior TDF, proteinuria improved (p\u2009&lt;\u20090.00096), but proximal tubular dysfunction proportions did not change. Fasting lipids, FRS, and the inflammation markers C-reactive protein and CD4:CD8 T-cell ratio remained stable. Lumbar spine BMD improved (+1.7%, p\u2009&lt;\u20090.00096), while hip BMD and TBS remained comparable. Simplification of TDF-containing cART to DTG monotherapy ameliorated lumbar spine BMD and proteinuria with neutral effect on lipids and inflammation markers. Although DTG monotherapy should not be used in routine care and its role in strictly selected patients with primary HIV infection needs to be further elucidated, these observations remain relevant regarding DTG-based dual therapy without TDF. www.clinicaltrials.gov registration number: NCT02401828.<\/jats:p>","DOI":"10.1177\/0956462419848962","type":"journal-article","created":{"date-parts":[[2019,8,21]],"date-time":"2019-08-21T02:24:41Z","timestamp":1566354281000},"page":"1042-1048","update-policy":"https:\/\/doi.org\/10.1177\/sage-journals-update-policy","source":"Crossref","is-referenced-by-count":5,"title":["Changes in renal, bone, lipid, and inflammation markers in HIV-1 patients after combination antiretroviral therapy simplification to dolutegravir monotherapy"],"prefix":"10.1177","volume":"30","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-7077-9887","authenticated-orcid":false,"given":"Ingeborg EA","family":"Wijting","sequence":"first","affiliation":[{"name":"Department of Internal Medicine and Infectious Diseases, Erasmus Medical Center, Erasmus University, Rotterdam, the Netherlands"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Casper","family":"Rokx","sequence":"additional","affiliation":[{"name":"Department of Internal Medicine and Infectious Diseases, Erasmus Medical Center, Erasmus University, Rotterdam, the Netherlands"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Maria C","family":"Zillikens","sequence":"additional","affiliation":[{"name":"Department of Internal Medicine and Endocrinology, Erasmus Medical Center, Erasmus University, Rotterdam, the Netherlands"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Sandra AA","family":"Smits","sequence":"additional","affiliation":[{"name":"Department of Internal Medicine and Endocrinology, Erasmus Medical Center, Erasmus University, Rotterdam, the Netherlands"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Theodora EMS","family":"de Vries-Sluijs","sequence":"additional","affiliation":[{"name":"Department of Internal Medicine and Infectious Diseases, Erasmus Medical Center, Erasmus University, Rotterdam, the Netherlands"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Carolina AM","family":"Schurink","sequence":"additional","affiliation":[{"name":"Department of Internal Medicine and Infectious Diseases, Erasmus Medical Center, Erasmus University, Rotterdam, the Netherlands"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Hannelore I","family":"Bax","sequence":"additional","affiliation":[{"name":"Department of Internal Medicine and Infectious Diseases, Erasmus Medical Center, Erasmus University, Rotterdam, the Netherlands"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Marchina E","family":"van der Ende","sequence":"additional","affiliation":[{"name":"Department of Internal Medicine and Infectious Diseases, Erasmus Medical Center, Erasmus University, Rotterdam, the Netherlands"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Eric CM","family":"van Gorp","sequence":"additional","affiliation":[{"name":"Department of Internal Medicine and Infectious Diseases, Erasmus Medical Center, Erasmus University, Rotterdam, the Netherlands"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Jan L","family":"Nouwen","sequence":"additional","affiliation":[{"name":"Department of Internal Medicine and Infectious Diseases, Erasmus Medical Center, Erasmus University, Rotterdam, the Netherlands"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Annelies","family":"Verbon","sequence":"additional","affiliation":[{"name":"Department of Internal Medicine and Infectious Diseases, Erasmus Medical Center, Erasmus University, Rotterdam, the Netherlands"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Wouter FW","family":"Bierman","sequence":"additional","affiliation":[{"name":"Department of Internal Medicine\/Infectious Diseases, University of Groningen, University Medical Center Groningen, Groningen, the Netherlands"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Bart JA","family":"Rijnders","sequence":"additional","affiliation":[{"name":"Department of Internal Medicine and Infectious Diseases, Erasmus Medical Center, Erasmus University, Rotterdam, the Netherlands"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"179","published-online":{"date-parts":[[2019,8,20]]},"reference":[{"key":"bibr1-0956462419848962","doi-asserted-by":"publisher","DOI":"10.1053\/j.ajkd.2011.01.022"},{"key":"bibr2-0956462419848962","doi-asserted-by":"publisher","DOI":"10.1089\/aid.2008.0202"},{"key":"bibr3-0956462419848962","doi-asserted-by":"publisher","DOI":"10.1093\/infdis\/jiv466"},{"key":"bibr4-0956462419848962","doi-asserted-by":"publisher","DOI":"10.1093\/infdis\/jiu107"},{"key":"bibr5-0956462419848962","doi-asserted-by":"publisher","DOI":"10.1093\/infdis\/jiw204"},{"key":"bibr6-0956462419848962","doi-asserted-by":"crossref","unstructured":"G\u00fcerri-Fern\u00e1ndez R, Molina-Morant D, Villar-Garc\u00eda J, et al. Bone density, microarchitecture, and tissue quality after long-term treatment with tenofovir\/emtricitabine or abacavir\/lamivudine.\n                      J Acquir Immune Defic Syndr\n                      2017; 75: 322\u2013327.","DOI":"10.1097\/QAI.0000000000001396"},{"key":"bibr7-0956462419848962","doi-asserted-by":"publisher","DOI":"10.1007\/s00198-012-2189-1"},{"key":"bibr8-0956462419848962","doi-asserted-by":"publisher","DOI":"10.1002\/jbmr.2734"},{"key":"bibr9-0956462419848962","doi-asserted-by":"publisher","DOI":"10.1093\/cid\/civ296"},{"key":"bibr10-0956462419848962","doi-asserted-by":"publisher","DOI":"10.1097\/QAI.0000000000001350"},{"key":"bibr11-0956462419848962","doi-asserted-by":"publisher","DOI":"10.1016\/S2352-3018(17)30152-2"},{"key":"bibr12-0956462419848962","doi-asserted-by":"publisher","DOI":"10.1007\/s40262-013-0093-2"},{"key":"bibr13-0956462419848962","doi-asserted-by":"publisher","DOI":"10.1161\/JAHA.114.000844"},{"key":"bibr14-0956462419848962","doi-asserted-by":"publisher","DOI":"10.1093\/infdis\/jiv123"},{"key":"bibr15-0956462419848962","doi-asserted-by":"crossref","first-page":"1","DOI":"10.1038\/kisup.2012.73","volume":"3","author":"Kidney Disease: Improving Global Outcomes (KDIGO) Chronic Kidney Disease Work Group.","year":"2013","journal-title":"Kidney Int Suppl"},{"key":"bibr16-0956462419848962","unstructured":"Copenhagen HIV Programme (CHIP). Framingham risk score tools, https:\/\/www.chip.dk\/Tools-Standards\/Clinical-risk-scores (accessed 9 May 2019)."},{"key":"bibr17-0956462419848962","doi-asserted-by":"publisher","DOI":"10.3109\/07853890.2012.732704"},{"key":"bibr18-0956462419848962","doi-asserted-by":"publisher","DOI":"10.3109\/00365548.2012.673730"},{"key":"bibr19-0956462419848962","doi-asserted-by":"crossref","unstructured":"Serrano-Villar S, Sainz T, Lee SA, et al. HIV infected individuals with low CD4\/CD8 ratio despite effective antiretroviral therapy exhibit altered T-cell subsets, heightened CD8+ T cell activation, and increased risk of non-AIDS morbidity and mortality.\n                      PLoS Pathog\n                      2014; 10: e1004078.","DOI":"10.1371\/journal.ppat.1004078"},{"key":"bibr20-0956462419848962","doi-asserted-by":"crossref","unstructured":"Hocqueloux L, Raffi F, Prazuck T, et\u00a0al. Dolutegravir monotherapy versus dolutegravir\/abacavir\/lamivudine for virologically suppressed people living with chronic HIV infection: the randomized non-inferiority MONCAY trial.\n                      Clin Infect Dis\n                      . Jan 2019 Epub ahead of print 2019. DOI: 10.1093\/cid\/ciy1132.","DOI":"10.1093\/cid\/ciy1132"},{"key":"bibr21-0956462419848962","doi-asserted-by":"crossref","unstructured":"Braun DL, Turk T, Tschumi F, et\u00a0al. Non-inferiority of simplified dolutegravir monotherapy compared to continued cART that was initiated during primary HIV infection: a randomized, controlled, multi-site, open-label, non-inferiority trial.\n                      Clin Infect Dis\n                      . Jan 2019 Epub ahead of print 2019. 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