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Omega-3 decreases interleukin-6 levels in HIV and HHV-8 co-infected patients: results from a randomized supplementation trial in Uganda.

Omega-3 decreases interleukin-6 levels in HIV and HHV-8 co-infected patients: results from a randomized supplementation trial in Uganda.
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Coghill AE, Schenk JM, Mahkoul Z, Orem J, Phipps W, Casper C,


Coghill AE, Schenk JM, Mahkoul Z, Orem J, Phipps W, Casper C, (click to view)

Coghill AE, Schenk JM, Mahkoul Z, Orem J, Phipps W, Casper C,

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AIDS (London, England) 2017 12 12() doi 10.1097/QAD.0000000000001722

Abstract
OBJECTIVE
Kaposi sarcoma (KS) is an HIV-associated malignancy caused by human herpesvirus-8 that occurs at highest incidence in sub-Saharan Africa. KS patients often present with inflammatory symptoms associated with higher mortality.

DESIGN
We conducted a double-blind, randomized, placebo-controlled study in Uganda to test whether omega-3 (ω-3) supplementation could reduce inflammation in HIV and HHV-8 co-infected adults ≥ 18 years of age. Patients with acute illness, AIDS, or advanced KS were ineligible, as were pregnant women. Participant IDs were pre-randomized, blocked by KS status, to either the ω-3 or placebo arm.

METHODS
ω-3 participants received a 3-gram pill dose daily for 12 weeks (1.8 g eicosapentaenoic acid, 1.2 mg docosapentaenoic acid); placebo participants received 44.8 mg of high oleic safflower oil that appeared indistinguishable from the active supplement. Intervention effects were evaluated as the baseline-adjusted mean differences after 12 weeks between ω-3 and placebo participants in concentrations of fatty acids, inflammatory cytokines, and immune cells.

RESULTS
The final study population was comprised of 56 KS patients and 11 KS-negative, HHV-8 positive participants randomized to receive either ω-3 (N = 33) or placebo (N = 34). Inflammatory cytokine interleukin-6 (IL-6) concentrations decreased in ω-3 participants (-0.78 pg/mL) but increased in placebo participants (+3.2 pg/mL;P- = 0.04). We observed a trend towards decreased IL-6 after ω-3 supplementation specific to KS patients (N = 58;P = 0.08). CD8+ counts tended to increase in the ω-3 arm KS patients (+60 cells/mm), while decreasing (-47 cells/mm) with placebo (P = 0.11).

CONCLUSION
ω-3 supplementation decreased Il-6 concentrations among HIV and HHV-8 co-infected Ugandans, which may have clinical benefit for KS patients.

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