The relationship between hiv, major depressive disorder and suicidal ideation is well established. For example, hiv-positive patients are seven times more likely to develop depression, and suicidal behaviour is also more prevalent. Antiretroviral therapy is known to further enhance these risks. We saw a 53-year-old patient with a depressive episode and suicidal ideation, possibly related to the use of dolutegravir/abacavir/lamivudine. We provide an overview of the literature and we present a neuro-immunological hypothesis for this psychiatric adverse event, which may occur even after months of treatment.