BOSTON — Daily ingestion of fish oil tablets can decrease blood lipid levels in HIV-infected patients with hypertriglyceridemia associated with antiretroviral drug therapy, according to the results of a French study.
The prospective investigation included 122 HIV-infected patients taking antiretroviral therapy (ART); 58 were randomized to receive two 1-g capsules of a fish oil supplement t.i.d. This group experienced a median 26% reduction in triglyceride levels from baseline. In contrast, the median triglyceride levels of patients given a placebo increased 1%, Pierre de Truchis, M.D., reported at a conference on retroviruses and opportunistic infections.
“Triglyceride levels normalized in 22% of the [fish oil] recipients, but in only 7% of the placebo group,” said Dr. de Truchis of Hôpital Raymond Poincaré, Garches, France. Neither total nor HDL cholesterol levels changed over the course of the study in either group.
During a subsequent 8-week open-label phase of the study, patients in the original fish oil group maintained their triglyceride reductions while continuing fish oil supplementation, and patients originally given placebo experienced a median 21% decrease with the switch to fish oil tablets, he said at the conference, sponsored by the Foundation for Retrovirology and Human Health.
At baseline, all of the patients in the study had triglyceride levels greater than 2 g/L with a mean triglyceride level of 4.5 g/L after 4 weeks of following an appropriate diet. Patients with baseline levels greater than 10 g/L were not randomized in the initial trial, but 10 such patients were included in the open-label phase. After 8 weeks of supplementation, this group experienced a 44% reduction in triglycerides, said Dr. de Truchis, suggesting that there was a benefit in patients with severe blood lipid elevation.
The fish oil supplements were well tolerated, and there were no significant differences in adverse events between groups, Dr. de Truchis said. Because of their efficacy and tolerability and the absence of drug interactions, fish oil supplements represent a potential first-line therapy for ART-associated hypertriglyceridemia. “Reducing blood lipid increases may lower the increased risk of cardiovascular disease associated with HIV infection and with antiretroviral therapy,” he said.
The fish oil supplementation in this study included a total of about 1 g/day each of the omega-3 fatty acids eicosapentaenoic acid and docosahexaenoic acid—the equivalent of two meals containing oily fish per day. This formulation has been shown to reduce LDL cholesterol and triglyceride levels in adults without infection, according to Dr. De Truchis.