Plasma n-6 Fatty Acid Levels Are Associated With CD4 Cell Counts, Hospitalization, and Mortality in HIV-Infected Patients
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Date
2016
Journal Title
Journal ISSN
Volume Title
Publisher
Journal of acquired immune deficiency syndromes
Abstract
Fatty acids, including n-6 series, modulate immune
function, but their effect on CD4 cell counts, death, or hospitalization
in HIV-infected patients on antiretroviral therapy is unknown.
Methods: In a randomized trial for effects of multivitamins in HIVinfected
patients in Uganda, we used gas chromatography to measure
plasma n-6 fatty acids at baseline; determined CD4 counts at
baseline, 3, 6, 12, and 18 months; and recorded hospitalization or
death events. The associations of fatty acids with CD4 counts and
events were analyzed using repeated-measures analysis of variance
and Cox regression, respectively.
Results: Among 297 patients with fatty acids measurements, 16
patients died and 69 were hospitalized within 18 months. Except for
linoleic acid, n-6 fatty acids levels were positively associated with
CD4 counts at baseline but not during follow-up. In models that
included all 5 major n-6 fatty acids, age; sex; body mass index;
anemia status; use of antiretroviral therapy, multivitamin supplements,
and alcohol; and the risk of death or hospitalization decreased
significantly with an increase in linoleic acid and gamma-linolenic
acid levels, whereas associations for dihomo-gamma-linolenic acid,
arachidonic acid, and aolrenic acid were null. The hazard ratios (95%
confidence intervals) per 1 SD increase in linoleic acid and gammalinolenic
acid were 0.73 (0.56–0.94) and 0.51 (0.36–0.72), respectively.
Gamma-linolenic acid remained significant (hazard ratio =
0.51; 95% confidence interval: 0.35 to 0.68) after further adjustment
for other plasma fatty acids.
Conclusions: Lower levels of gamma-linolenic acid are associated
with lower CD4 counts and an increased risk of death or
hospitalization. These results suggest a potential for using n-6 fatty
acids to improve outcomes from antiretroviral therapy.
Description
Keywords
Antiretroviral therapy, Fatty acids, n-6 fatty acids, Mortality, Hospitalization, HIV
Citation
Kabagambe, E. K., Ezeamama, A. E., Guwatudde, D., Campos, H., & Fawzi, W. (2016). Plasma n6-fatty acid levels are associated with CD4 cell counts, hospitalization and mortality in HIV-infected patients. Journal of acquired immune deficiency syndromes (1999), 73(5), 598.