Avaliação do Ômega 3 como imunofarmaconutriente em pacientes com HIV/AIDS : estudo clínico randomizado

Abstract

Antiretroviral treatment based on regimens containing at least three drugs has been shown to be effective in reducing morbidity and mortality associated with HIV infection. However, antiretroviral therapy can induce serious metabolic complications, such as insulin resistance, metabolic syndrome, lipodystrophy and cardiovascular diseases. Schemes that include Protease Inhibitors are more closely associated with these changes. Omega-3 fatty acids, which are polyunsaturated lipids, have been indicated in the situations described above because of the benefits it provides (anti-inflammatory, antiarrhythmics, antiplatelet agent, with improved endothelial function). However, studies evaluating immunological effects are rare in this population. Objective: To evaluate the metabolic and immunological effect of omega 3, administered orally, in HIV / AIDS patients, using antiretroviral therapy. Methods: We included 40 adult patients, both male and female, over 18 years of age and with reactive serology for HIV infection, considered to have adhered to antiretroviral therapy for more than 1 year. They were randomized into two groups of 20 patients: group A (4g / day - omega 3) and group B (4g / day - maltodextrin). The intervention was uninterrupted for 90 days and the variables analyzed included TCD4+, TCD8+, TCD4+/TCD8+ and CD45 ratio, lipidogram, glycemia, serum insulin, and insulin resistance. The anthropometric measures (weight and abdominal circumference) and body composition (muscle mass, fat mass and fat percentage) were also evaluated. The variables were analyzed on days 1 ° (T0), 45 ° (T45) and 90 ° (T90) days. Results: Among the characteristics of the participants at the beginning of the investigation, only the time (years) of antiretroviral therapy was higher in group A (6.5 ± 2.8 vs 4.7 ± 2.0; p = 0.02). The variables of anthropometric measures and body composition showed no difference, as well as those of immunological evaluation. However, in relation to the biochemical analysis, we observed a decrease in insulin and insulin resistance in group A between T45 and T90 days (p <0.01 and p = 0.01, respectively). Conclusion: The administration of 4 g / day omega 3 for 90 consecutive days in patients taking antiretroviral therapy results in a reduction in insulin values and insulin resistance. However, it does not present positive results for the immunological evaluation.