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

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.