Effect of Soluble Fiber on Hypertriglyceridemia and Immune Profile in HIV-positive Individuals.
Condition: Hypertriglyceridemia; HIV Infections
MeSH terms: Hypertriglyceridemia
Study type: Interventional

Summary: 
      The purpose of this study was to assess the effect of soluble fiber® (partially hydrolyzed
      guar gum) supplementation on hypertriglyceridemia and immune profile in HIV-positive
      individuals on HAART.
    

Detailed description: 
      Since 1996, the advent of highly active antiretroviral therapy (HAART) has caused a profound
      impact on the natural history of HIV-infection by promoting important and sustainable viral
      replication suppression and increasing survival and quality of life among seropositive
      patients. Nonetheless, antiretroviral therapy has been observed to be accompanied by
      metabolic alterations such as dyslipidemia, especially hypertriglyceridemia, insulin
      resistance, hyperglycemia and lipodystrophy (body fat redistribution). Epidemiological
      studies have demonstrated a correlation between high triglyceride (TG) levels and higher
      incidence of coronary artery disease (CAD). Some investigators suggest dietary intervention
      as part of hyperlipidemia treatment, including an increase in soluble fiber intake
      (10-25g/day). Whereas some studies have demonstrated that both cholesterol and serum
      triglyceride levels decrease with the use of food fiber, others have shown just a serum
      triglyceride increase, and others failed to observe any alteration in lipid metabolism. The
      purpose of this study was to assess the effect of soluble fiber® (partially hydrolyzed guar
      gum) supplementation on hypertriglyceridemia and immune profile in HIV-positive individuals
      on HAART. Nineteen HIV-positive individuals with hypertriglyceridemia (serum levels ≥ 200 to
      ≤ 500 mg/dL) were studied. Of these individuals, 63.16% were males (mean age of 38.52±9.29
      years) who had been on the same HAART regimen for at least 6 months, had no change in therapy
      during the study and received 20g/day of soluble fiber for 4 months at pre-established times.
      Clinical-nutritional, biochemical (total proteins, albumin, globulin, total cholesterol,
      LDL-c, HDL-c, TG, TG/HDL-c and LDL-c/HDL-c), hemoximetric (hemoglobin, hematocrit and total
      lymphocytes), and immunologic (lymphocytes T CD4+, T CD8+; T CD4+/CD8+ ratio, viral load,
      TNFα- and IL-6) parameters were assessed in all patients at three time points
      (M0-pretreatment, M1-30 days and M2-4 months after intervention). Significance level was set
      5% for all data statistically analyzed. Serum TG and TG/HDL-c ratio reduction was observed at
      all time points, but statistical significance was found just at M0 and M2. The remaining
      biochemical, hemoximetric and immunologic parameters (lymphocytes T CD4+, T CD8+; T CD4+/CD8+
      ratio, and viral load) showed no significant difference at all times. Regarding serum
      cytokines, TNFα- and IL-6 significantly decreased between M0 and M2, and only IL-6 reduced
      between M1 and M2. The data collected show that dietary and anthropometric parameters
      remained unchanged excluding potential confounding factors related with the effect of fiber
      supplementation on serum TG, TNFα- and IL-6. Thus, soluble fiber® (partially hydrolyzed guar
      gum) contributed to an important reduction in hypertriglyceridemia and in the serum levels of
      the proinflammatory cytokines TNFα- and IL-6 in HIV-seropositive individuals on HAART. In
      addition, soluble fiber® (partially hydrolyzed guar gum) might have minimized the process of
      atherosclerosis in these individuals, given that elevated serum levels of TG, TNFα- and IL-6
      have been associated with the development of these lesions.
    

Intervention name(s): soluble fiber® (partially hydrolyzed guar gum)
Intervention type(s): Dietary Supplement
Intervention description(s): HIV-positive individuals with hypertriglyceridemia and who had been on the same HAART regimen for at least 6 months, had no change in therapy during the study,received 20g/day of soluble fiber for 4 months at pre-established times.
Other intervention name(s): Benefiber® (Novartis)
Intervention model: Single Group Assignment
Masking: None (Open Label)
Primary purpose: Treatment
Keywords: Soluble fiber; HIV/aids; Hypertriglyceridemia; Cytokines; Alternative Medicine; Complementary Medicine