Fish Oil and Fenofibrate for the Treatment of Hypertriglyceridemla in HIV-Infected Subjects on Antlretroviral Therapy: Results of ACTG A5186

Introduction: Fish oil has been shown to reduce serum triglyceride (TG) concentrations. In HIV-infected patients on antiretroviral therapy, high TG concentrations likely contribute to Increased risk of cardiovascular disease. AIDS Clinical Trials Group A5186 examined the safety and efficacy offish oil plus fenofibrate in subjects not achieving serum TG levels =400 mg/dL and low-density lipoprotein cholesterol 200 mg/dL at week 8 received a combination of fish oil and fenofibrate in the same doses from week 10 to week 18. Results: Median baseline TG was 662 mg/dL in the fish oil group and 694 mg/dL in the fenofibrate group (P = not significant). Fish oil reduced TG levels by a median of 283 mg/dL (46%), fenofibrate reduced them by 367 mg/dL (58%), and combination therapy reduced them by 65.5%. Combination therapy achieved TG levels of