The effects of dietary intervention on HIV dyslipidaemia: a systematic review and meta-analysis.
BACKGROUND
Efficacy of dietary intervention for treatment and prevention of HIV-related lipid disturbances has not been well established.


METHODS
We conducted a systematic search of electronic databases supplemented with manual searches and conference abstracts, without language restriction. All randomised controlled trials (RCTs) with blood lipid outcomes, involving dietary intervention or supplementation for the treatment or prevention of adult HIV dyslipidaemia, versus no or other intervention were included. Two authors using predefined data fields, including study quality indicators, extracted data independently.


RESULTS
Eighteen studies (n = 873) met our inclusion criteria. Seven RCTs for omega-3 supplementation (n = 372), and four RCTs for dietary intervention (n = 201) were meta-analysed using random-effects models. Mild statistical heterogeneity was observed. Dietary intervention reduced triglyceride levels by -0·46 mmol/l (95%CI: -0·85 to -0·07 mmol/l) compared to control. Omega-3 supplementation reduced triglyceride levels by -1.12 mmol/l, (95%CI: -1·57 to -0·67 mmol/l) and total cholesterol, -0·36 mmol/l (95%CI: -0·67 to -0·05 mmol/l) compared to placebo/control.


CONCLUSIONS
Both omega-3 supplementation and dietary intervention reduced triglyceride level, with the latter possibly to a smaller extent. While dietary interventions are beneficial, more stringent dietary approaches may be necessary to fully address lipid disturbances in HIV patients.


BACKGROUND
PROSPERO 2011:CRD42011001329.
HIV Metabolic Clinic, Heart of England NHS Foundation Trust, Birmingham, United Kingdom. clare.stradling@heartofengland.nhs.uk
Clare
C
Stradling
Yen-Fu
YF
Chen
Tracy
T
Russell
Martin
M
Connock
G Neil
GN
Thomas
Shahrad
S
Taheri
D002784:Cholesterol / Q000097:blood; D019587:Dietary Supplements; D050171:Dyslipidemias / Q000178:diet therapy* / Q000188:drug therapy / Q000209:etiology*; D015525:Fatty Acids, Omega-3 / Q000627:therapeutic use; D015658:HIV Infections / Q000150:complications*; D006801:Humans; D015233:Models, Statistical; D016032:Randomized Controlled Trials as Topic; D016896:Treatment Outcome; D014280:Triglycerides / Q000097:blood
D015525:Fatty Acids, Omega-3; D014280:Triglycerides; D002784:Cholesterol