Omega-3s decreased median triglycerides and CRP in HIV patients on ART

NEW ORLEANS — A high daily dose of omega-3 fatty acids decreased median triglycerides more than placebo and significantly reduced median C-reactive protein in HIV-infected patients on stable ART, according to findings presented at IDWeek 2016.

Cardiovascular disease is prevalent in HIV-infected individuals, said Gretchen Volpe, MD, MPH, assistant professor at Tufts University School of Medicine and attending physician in the division of infectious diseases and geographic medicine at Tufts Medical Center.

“HIV increases cardiovascular disease through several pathways, including dyslipidemia, chronic inflammation and vascular dysfunction,” she said during a presentation here.

Volpe and colleagues conducted what she said was the longest randomized control trial of high-dose omega-3 fatty acids in HIV-infected patients to evaluate the long-term effects on lipids, inflammation and vascular function.

Although prior studies were limited to 24 weeks or less, Volpe and colleagues conducted their study over 24 months. They randomly assigned 117 HIV-infected patients on stable ART either 4 g of purified omega-3 fatty acids per day (n = 61) or placebo (n = 56). The mean age of the patients was 51 years, 21% were women, and 95% were virologically suppressed.

After 24 months, triglycerides fell 68 mg/dL in the treatment arm and 22 mg/dL in the placebo arm.The change in C-reactive protein was –0.3 mg/L in the treatment arm vs. +0.6 mg/L (P = .008) for those on placebo.

There were no significant differences in HDL cholesterol or brachial artery reactivity between the two groups, and serious adverse events did not differ.

While the results showed that long-term omega-3 fatty acid supplementation can reduce triglycerides and may mitigate chronic inflammation in HIV-positive patients, Volpe said more than 24 months of treatment may be needed to study whether such treatment has a true effect on vascular function.

“Omega-3 fatty acid supplementation was well-tolerated with limited side effects,” Volpe said. “Efficacy may increase over time, as the differences in triglycerides and CRP were not statistically significant at 12 months but they were at 24 months.” – by Gerard Gallagher

Reference:

Volpe G, et al. Abstract 951. Presented at: IDWeek; Oct. 26-30, 2016; New Orleans.

Disclosures: Volpe reports no relevant financial disclosures. Please see the full study for a list of all other authors’ relevant financial disclosures.