Fish oil and fenofibrate for the treatment of hypertriglyceridemia in HIV-infected subjects on antiretroviral therapy: results of ACTG A5186.

TitleFish oil and fenofibrate for the treatment of hypertriglyceridemia in HIV-infected subjects on antiretroviral therapy: results of ACTG A5186.
Publication TypeJournal Article
Year of Publication2008
AuthorsGerber JG, Kitch DW, Fichtenbaum CJ, Zackin RA, Charles S, Hogg E, Acosta EP, Connick E, Wohl D, E Kojic M, Benson CA, Aberg JA
JournalJ Acquir Immune Defic Syndr
Volume47
Issue4
Pagination459-66
Date Published2008 Apr 1
ISSN1525-4135
KeywordsAdult, Cholesterol, HDL, Cholesterol, LDL, Drug Therapy, Combination, Female, Fenofibrate, Fish Oils, HIV Infections, Humans, Hypertriglyceridemia, Hypolipidemic Agents, Male, Middle Aged, Time Factors, Treatment Outcome, Triglycerides
Abstract

INTRODUCTION: Fish oil has been shown to reduce serum triglyceride (TG) concentrations. In HIV-infected patients on antiretroviral therapy, high TG concentrations likely contribute to increased risk of cardiovascular disease. AIDS Clinical Trials Group A5186 examined the safety and efficacy of fish oil plus fenofibrate in subjects not achieving serum TG levels < or =200 mg/dL with either agent alone.

METHODS: One hundred subjects on highly active antiretroviral therapy with serum TG concentrations > or =400 mg/dL and low-density lipoprotein cholesterol < or =160 mg/dL were randomized to 3 g of fish oil twice daily or 160 mg of fenofibrate daily for 8 weeks. Subjects with a fasting TG level >200 mg/dL at week 8 received a combination of fish oil and fenofibrate in the same doses from week 10 to week 18.

RESULTS: Median baseline TG was 662 mg/dL in the fish oil group and 694 mg/dL in the fenofibrate group (P = not significant). Fish oil reduced TG levels by a median of 283 mg/dL (46%), fenofibrate reduced them by 367 mg/dL (58%), and combination therapy reduced them by 65.5%. Combination therapy achieved TG levels of < or =200 mg/dL in 22.7% subjects. Fish oil had no measurable effect on immunologic parameters or the pharmacokinetics of lopinavir.

CONCLUSIONS: Fish oil was safe when administered alone or combined with fenofibrate and significantly reduced TG levels in HIV-infected subjects with hypertriglyceridemia.

DOI10.1097/QAI.0b013e31815bace2
Alternate JournalJ. Acquir. Immune Defic. Syndr.
PubMed ID17971707
PubMed Central IDPMC2788607
Grant List3 U01 AI 32775-13S3 / AI / NIAID NIH HHS / United States
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