Docosahexanoic acid (DHA) supplementation in patients with HIV receiving combination antiretroviral therapy (cART) lowered triglyceride levels significantly, according to a study in Clinical Nutrition.1
Researchers conducted a double-blind, placebo-controlled trial (Effect of DHA on Lipid and Carbohydrate Metabolism Alternations and Body Fat Distribution in HIV Patients Under HAART; ClinicalTrials.gov identifier NCT02005900) of 84 people with HIV, who randomly received either 4 g/day of DHA or 7 g/day of placebo (olive oil) for 48 weeks. Primary study end point was patient’s percent change in triglyceride level at 4 weeks, based on previous research suggesting that the maximum effect of lipid-lowering strategies occurs within the first 4 to 6 weeks of intervention.2 The trial was extended an additional 44 weeks to ascertain more fully the tolerability and safety of DHA and to collect fat data.
Eighty patients (95%) completed the week 4 study evaluation and 77 (88.5%) completed the week 12 evaluation. Patients receiving DHA had a 43.9% median decline in fasting triglyceride levels at week 4 vs a 2.9% decline in the placebo group (P <.0001). The difference remained statistically significant at week 48 (P =.0253).
Low-density lipoprotein cholesterol levels in the DHA group increased by 7.1% at week 4; no change was noted in the placebo group. Limb fat increased significantly for both groups, but the between-group difference was not statistically significant. DHA was well tolerated by all but 3 participants, who had treatment-limiting toxicity. Assessments of peripheral fat showed that it increased significantly for the DHA group but was not significantly greater than in the placebo group.
- Domingo P, Fernández I, Gallego-Escuredo JM, et al. Effects of docosahexanoic acid on metabolic and fat parameters in HIV-infected patients on cART: A randomized, double-blind, placebo-controlled study [published online June 8, 2017]. Clin Nutr. doi:10.1016/j.clnu.2017.05.032
- Stone NJ, Robinson JG, Lichtenstein AH, et al; for the American College of Cardiology/American Heart Association Task Force on Practice Guidelines. 2013 ACC/AHA guideline on the treatment of blood cholesterol to reduce atherosclerotic cardiovascular risk in adults: a report of the American College of Cardiology/American Heart Association Task Force on Practice Guidelines. J Am Coll Cardiol. 2014;63(25 Pt B):2889-2934.