Dietary intervention when starting HAART prevents the increase in lipids independently of drug regimen: a randomized trial
Objectives: To evaluate the effects of dietary intervention in blood lipids from HIV positive individuals who started HAART.
Methods: Ninety HIV infected patients who started treatment were randomized to receive HAART with dietary intervention or HAART without dietary intervention (control group) for 12 months. Dietary intervention, according to the National Cholesterol Education Program (NCEP), was given every 3 months. Before and after intervention, 24 h food records, body mass index (BMI), weight/hip ratio, and lipid profile were obtained. Data were analyzed by intention to treat, using mixed-effects models. Dyslipidemia was considered according to NCEP guidelines.
Results: Baseline characteristics were similar between groups. Data presented are from 80 individuals (42 in the intervention group and 38 in controls). Dietary intervention resulted in reduction in total caloric intake (mean ± SD: from 2,655±619 to 2,289±516 Kcal/day) and percentage of fat intake (from 31±7 to 21±3 % of calories), while controls increased caloric intake (from 2,600±569 to 2,814±669 Kcal/day), with no change in percentage of fat intake. BMI (from 23±3 to 26±4 Kg/m2) and waist/hip ratio (from 0.86±0.05 to 0.91±0.06) increased in the controls and were unchanged by dietary intervention. Plasma cholesterol (from 150±29 to 189±34 mg/dL) and LDL-cholesterol (from 85±25 to 106±31 mg/dL) increased in the controls and were unchanged in the dietary intervention group. Plasma triglycerides were reduced by dietary intervention (from 134±67 to 101±42 mg/dL) and increased in controls (from 134±70 to 158±77 mg/dL). After one year follow-up, 17% of patients who received dietary intervention developed dyslipidemia, while 50% (p < 0.05) of controls had dyslipidemia.
Conclusions: This randomized trial shows that dietary intervention is able to prevent an elevation in lipids blood levels (total cholesterol and LDL-cholesterol) or even a decrease (triglycerides) in individuals who start HAART independently of drug regimen. This simple aproach is safe and should be incorporated into clinical care.
4th IAS Conference on HIV Pathogenesis, Treatment and Prevention
"LazzarettiR., et al.
Dietary intervention when starting HAART prevents the increase in lipids independently of drug regimen: a randomized trial.
Oral abstract session:
4th IAS Conference on HIV Pathogenesis, Treatment and Prevention: