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Dietary intervention prevents dyslipidemia associated with highly active antiretroviral therapy in human immunodeficiency virus type 1-infected individuals: a randomized trial.

Abstract

OBJECTIVES

The purpose of this study was to evaluate the efficacy of dietary intervention on blood lipids of human immunodeficiency virus (HIV)-1-infected patients who are started on highly active antiretroviral therapy (HAART).

BACKGROUND

Current guidelines recommend diet as first-step intervention for HIV-1-infected individuals with HAART-related dyslipidemia, but there is no evidence from randomized trials to support this recommendation.

METHODS

Eighty-three HIV-1-infected patients, naive from HAART, were randomly assigned to HAART with dietary intervention (diet group, n = 43) or HAART without dietary intervention (control group, n = 40) for 12 months. Diet, according to the National Cholesterol Education Program, was given every 3 months. Before and after intervention, 24-h food records and lipid profile were obtained. Data were analyzed by intention to treat, using mixed-effects models.

RESULTS

Diet resulted in reduction of percentage of fat intake (from 31 ± 7% to 21 ± 3% of calories), while controls presented no change in percentage of fat intake. Plasma cholesterol (from 151 ± 29 mg/dl to 190 ± 33 mg/dl) and low-density lipoprotein cholesterol (from 85 ± 24 mg/dl to 106 ± 31 mg/dl) increased in the control group and were unchanged in the diet group. Plasma triglycerides were reduced by diet (from 135 ± 67 mg/dl to 101 ± 42 mg/dl) and increased in the control group (from 134 ± 70 mg/dl to 160 ± 76 mg/dl). After 1-year follow-up, 21% of patients who received diet had lipid profile compatible with dyslipidemia compared with 68% (p < 0.001) of controls.

CONCLUSIONS

Among HIV-1-positive individuals naive of previous treatment, diet prevents dyslipidemia associated with HAART. (Effect of Nutritional Intervention on the Lipid Profile of HIV-Positive Patients Who Start HAART: a Randomized Trial; NCT00429845).

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  • Authors+Show Affiliations

    ,

    Cardiology Division, Hospital de Clínicas de Porto Alegre, Rua Ramiro Barcelos 2350, Porto Alegre, Brazil.

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    MeSH

    Adult
    Anthropometry
    Antiretroviral Therapy, Highly Active
    Cholesterol
    Dyslipidemias
    Female
    HIV Infections
    HIV-1
    Humans
    Male
    Middle Aged
    Triglycerides

    Pub Type(s)

    Journal Article
    Randomized Controlled Trial
    Research Support, Non-U.S. Gov't

    Language

    eng

    PubMed ID

    22402068

    Citation

    Lazzaretti, Rosmeri K., et al. "Dietary Intervention Prevents Dyslipidemia Associated With Highly Active Antiretroviral Therapy in Human Immunodeficiency Virus Type 1-infected Individuals: a Randomized Trial." Journal of the American College of Cardiology, vol. 59, no. 11, 2012, pp. 979-88.
    Lazzaretti RK, Kuhmmer R, Sprinz E, et al. Dietary intervention prevents dyslipidemia associated with highly active antiretroviral therapy in human immunodeficiency virus type 1-infected individuals: a randomized trial. J Am Coll Cardiol. 2012;59(11):979-88.
    Lazzaretti, R. K., Kuhmmer, R., Sprinz, E., Polanczyk, C. A., & Ribeiro, J. P. (2012). Dietary intervention prevents dyslipidemia associated with highly active antiretroviral therapy in human immunodeficiency virus type 1-infected individuals: a randomized trial. Journal of the American College of Cardiology, 59(11), pp. 979-88. doi:10.1016/j.jacc.2011.11.038.
    Lazzaretti RK, et al. Dietary Intervention Prevents Dyslipidemia Associated With Highly Active Antiretroviral Therapy in Human Immunodeficiency Virus Type 1-infected Individuals: a Randomized Trial. J Am Coll Cardiol. 2012 Mar 13;59(11):979-88. PubMed PMID: 22402068.
    * Article titles in AMA citation format should be in sentence-case
    TY - JOUR T1 - Dietary intervention prevents dyslipidemia associated with highly active antiretroviral therapy in human immunodeficiency virus type 1-infected individuals: a randomized trial. AU - Lazzaretti,Rosmeri K, AU - Kuhmmer,Regina, AU - Sprinz,Eduardo, AU - Polanczyk,Carísi A, AU - Ribeiro,Jorge P, PY - 2011/06/28/received PY - 2011/10/31/revised PY - 2011/11/30/accepted PY - 2012/3/10/entrez PY - 2012/3/10/pubmed PY - 2012/4/24/medline SP - 979 EP - 88 JF - Journal of the American College of Cardiology JO - J. Am. Coll. Cardiol. VL - 59 IS - 11 N2 - OBJECTIVES: The purpose of this study was to evaluate the efficacy of dietary intervention on blood lipids of human immunodeficiency virus (HIV)-1-infected patients who are started on highly active antiretroviral therapy (HAART). BACKGROUND: Current guidelines recommend diet as first-step intervention for HIV-1-infected individuals with HAART-related dyslipidemia, but there is no evidence from randomized trials to support this recommendation. METHODS: Eighty-three HIV-1-infected patients, naive from HAART, were randomly assigned to HAART with dietary intervention (diet group, n = 43) or HAART without dietary intervention (control group, n = 40) for 12 months. Diet, according to the National Cholesterol Education Program, was given every 3 months. Before and after intervention, 24-h food records and lipid profile were obtained. Data were analyzed by intention to treat, using mixed-effects models. RESULTS: Diet resulted in reduction of percentage of fat intake (from 31 ± 7% to 21 ± 3% of calories), while controls presented no change in percentage of fat intake. Plasma cholesterol (from 151 ± 29 mg/dl to 190 ± 33 mg/dl) and low-density lipoprotein cholesterol (from 85 ± 24 mg/dl to 106 ± 31 mg/dl) increased in the control group and were unchanged in the diet group. Plasma triglycerides were reduced by diet (from 135 ± 67 mg/dl to 101 ± 42 mg/dl) and increased in the control group (from 134 ± 70 mg/dl to 160 ± 76 mg/dl). After 1-year follow-up, 21% of patients who received diet had lipid profile compatible with dyslipidemia compared with 68% (p < 0.001) of controls. CONCLUSIONS: Among HIV-1-positive individuals naive of previous treatment, diet prevents dyslipidemia associated with HAART. (Effect of Nutritional Intervention on the Lipid Profile of HIV-Positive Patients Who Start HAART: a Randomized Trial; NCT00429845). SN - 1558-3597 UR - https://www.unboundmedicine.com/medline/citation/22402068/Dietary_intervention_prevents_dyslipidemia_associated_with_highly_active_antiretroviral_therapy_in_human_immunodeficiency_virus_type_1_infected_individuals:_a_randomized_trial_ L2 - https://linkinghub.elsevier.com/retrieve/pii/S0735-1097(11)05357-5 DB - PRIME DP - Unbound Medicine ER -