ACTG A5186 FISH OIL AND FENOFIBRATE IN SUBJECTS ON HAART

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This subproject is one of many research subprojects utilizing the resources provided by a Center grant funded by NIH/NCRR. The subproject and investigator (PI) may have received primary funding from another NIH source, and thus could be represented in other CRISP entries. The institution listed is for the Center, which is not necessarily the institution for the investigator. The use of protease inhibitors (PIs), in the treatment of HIV-infection is associated with lipid abnormalities that include most prominently elevations in serum very low-density lipoprotein (VLDL) triglycerides. This is most frequently observed with ritonavir-containing regimens, but other PIs, like nelfinavir, can cause these lipid changes as well. Perhaps the most significant concern is the mounting evidence that some HIV/antiretroviral treatment-associated metabolic disturbances may accelerate the development of athrerosclerosis leading to higher rates of ischemic cardiovascular and cerebrovascular disease. Omega-3 fatty acids have been used for the treatment of hypertriglyceridemia for over two decades the salutary effect of omega-3 fatty acids on cardiovascular health came from the observation that Greenland Eskimos, whose diet contains fat with omega-3 fatty acids, have a low incidence of coronary heart disease and strokes. The hypothesis of this study is that fish oil supplement or fenofibrate alone are inadequate to treat the majority of persons on HAART with hypertriglyceridema, and the combination of fish oil supplement with fenofibrate will result in a significantly improved efficacy in lowering serum triglycerides compared to either therapy alone.