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Title:	Efficacy of omega-3 fatty acids and D-α-tocopherol supplementation on metabolic and immunological status among asymptomatic male HIV positive subjects recieving antiretroviral medication at Hospital Sungai Buloh, Malaysia
Authors:	Nazisa Hejazi (P53375)
Supervisor:	Roslee Rajikan, Assoc. Prof. Dr.
Keywords:	HIV (Human Immune Deficiency Syndrome) ARV (Anti-Retroviral) Omega-3 Dissertations, Academic -- Malaysia Universiti Kebangsaan Malaysia -- Dissertations
Issue Date:	3-Sep-2016
Description:	Metabolic abnormalities are highly prevalent among HIV (Human Immune Deficiency Syndrome) population receiving anti HIV medications. Nutritional approaches may have beneficial effects on blood lipid disorders. Thus this single-blind randomized control trial aimed to evaluate the efficacy of omega-3 fatty acids and d-α-tocopherol supplementations either alone or in combination, after 6 months supplementation, on metabolic and immunological status of asymptomatic male HIV positive subjects receiving ARV (Anti-Retroviral) medication at Hospital Sungai Buloh, Malaysia. This study also evaluated the prevalence of blood metabolic and immunological complications and the predictors of blood metabolic and immunological disorders among HIV positive subjects. A total of 2739 HIV subjects on ARV medication were involved in the population study for screening (phase I) while in phase II (intervention), 165 HV male subjects were recruited and divided according to block randomization into one of the four groups of fish oil, vitamin E, fish oil + vitamin E and control with at least 40 subjects in each group. Nutritional status parameters including anthropometric measurements, biochemical tests [lipid, fasting plasma glucose (FPG), liver, renal], haematology and immunology as well as dietary intake were obtained during baseline visit and repeated in month 3 and month 6 intervention phase. Questionnaires were also administered to measure malnutrition using Patient-Generated Subjective Global Assessment (SGA), physical activity level using International Physical Activity, quality of life according to WHO-Quality of Life, depression and anxiety prevalence according to Hospital Anxiety and Depression Scale. All subjects in intervention phase had co-intervention with lifestyle guideline. Screening data showed that high TG (59.1%) and high TC level (54.2 %) were the most prevalent lipid disorders followed by raised FPG (38.2%), high LDL (35.1%) and low HDL level (28.7 %). The mean age of subjects was 40.38 + 8.74 (years) and 14.5 (%) had hepatitis. Current smokers were 32 (%) and 13.3 (%) had family history of CVDs in baseline data. Around 35.2 (%) of subjects had anxiety and depression 32.7 (%) while 37 (%) had low physical activity and only 23.6 (%) were malnourished. The average energy intake of subjects was 2070.94 + 286.32 (kcal/day) and the percentage of fat intake was 31.57 + 5.45 (%). Half of subjects (50%) had lower intake of iron while a majority of subjects had lower intakes of folate and vitamin E (98.1%). The most important results were the significant effects of supplementations on TG level. All groups had reductions in TG levels at the end of trial. After 6 months of trial the highest reduction in mean TG level was seen in omega-3 fatty acids + d-α-tocopherol group (20.5%) followed by omega-3 fatty acids group (17.7%), control group (6.1%) and d-α-tocopherol group (3%) and the difference in TG reduction was significant between groups (p = 0.018). The effects of supplementation on other lipid profile parameters were minimal, d-α-tocopherol increased HDL level by 10% while omega-3 fatty acids + d-α-tocopherol had raised HDL level by 7%. The subjects in groups who were supplemented with omega-3 fatty acids or omega-3 fatty acids + d-α-tocopherol had around 7% reduction in fasting plasma glucose. In conclusion, supplementation with omega-3 fatty acids or omega-3 fatty acids + d-α-tocopherol improved hypertriglycemia significantly. There is a need for further and comprehensive interventions with new nutritional/dietary approaches to address these nutritional complications to a level of substantial alleviation in HIV individual without or with anti-HIV treatment.,Ph.D.
Pages:	343
Call Number:	QV20.5.H473e 2016 9 tesis
Publisher:	UKM, Kuala Lumpur
Appears in Collections:	Faculty of Health Sciences / Fakulti Sains Kesihatan

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