Effects of fish oil on lipid profile and other metabolic outcomes in HIV-infected patients on antiretroviral therapy: a randomized placebo-controlled trial

Abstract

Although antiretroviral therapy has revolutionized the care of HIV-infected patients, it has been associated with metabolic abnormalities. Hence, this study was planned to investigate the effects of fish oil on lipid profile, insulin resistance, and body fat distribution in HIV-infected Brazilian patients on antiretroviral therapy, considering that marine omega-3 fatty acids seem to improve features of the metabolic syndrome. We conducted a randomized, parallel, placebo-controlled trial that assessed the effects of 3 g fish oil/day (540 mg of eicosapentaenoic acid plus 360 mg of docosahexaenoic acid) or 3 g soy oil/day (placebo) on 83 HIV-infected Brazilian men and non-pregnant women on antiretroviral therapy. No statistically significant relationships between fish oil supplementation and longitudinal changes in triglyceride (p = 0.335), low-density lipoprotein cholesterol (p = 0.078), high-density lipoprotein cholesterol (p = 0.383), total cholesterol (p = 0.072), apolipoprotein B (p = 0.522), apolipoprotein A1 (p = 0.420), low-density lipoprotein cholesterol/apolipoprotein B ratio (p = 0.107), homeostasis model assessment for insulin resistance index (p = 0.387), body mass index (p = 0.068), waist circumference (p = 0.128), and waist/hip ratio (p = 0.359) were observed. A low dose of fish oil did not alter lipid profile, insulin resistance, and body fat distribution in HIV-infected patients on antiretroviral therapy.

Effectiveness of n-3 fatty acids in the treatment of hypertriglyceridemia in HIV/AIDS patients: a meta-analysis

“…The same thing happens with the initial triglicerides dosage 15,16 . New clinical trials were published [16][17][18] , and better answers are necessary to the questions mentioned above.…”

“…Omacor® -3360 mg 26,29 ; Maxepa® -2700 mg 25 ,1800 mg 27 ; Lovaza® -3360 mg 18 ; Coromega® -2900 mg 28 ; Salmon oil -900 mg 15 ; Fish oil -4000 mg 17 , 900 mg 16 The studies included in this revision are shown in Chart 1. Year variables, classification of Jadad et al 19 , EPA and DHA dosage and initial triglycerides were analyzed to evaluate heterogeneity.…”

“…Various TARV regimens were described, using protease inhibitors (PIs), NRTI (nucleoside analog reverse-transcriptase inhibitors) and NNRTI (non-nucleoside analog reverse-transcriptase inhibitors) in various combinations; and the stable use for a period of ≥ 2 months 27 ; ≥ 3 months 16,18,26,28,29 ; ≥ 6 months 15,17,25 was inclusion criteria.…”

“…Similar results to the encountered in the meta-analysis of Oliveira e Stradling 12,13 . The poor result of the triglycerides reduction in the present study can be explained by the inclusion of new clinical trials [16][17][18] with specific characteristics discussed next. The heterogeneity encountered was considered moderate according to Higgins &Thomp-son 22 .…”

“…The heterogeneity encountered was considered moderate according to Higgins &Thomp-son 22 . Two analysis of the subgroup were conducted, the first excluding the studies that used under 1000 mg EPA/DHA day 15,16 dosages and the second, excluding the studies with initial triglycerides under 200 mg/dL 16,29 ; in both studies, the heterogeneity was 0%.…”