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Polyunsaturated fatty acid intake is adversely related to liver function in HIV-infected subjects: the THUSA study^1,3

¹ From the School of Physiology, Nutrition, and Consumer Sciences, Faculty of Health Sciences, North-West University Potchefstroom Campus, Potchefstroom, Republic of South Africa

Background: Dietary fat intake in the South African population is increasing. This population also has a high prevalence of HIV infection. However, information about metabolic effects of dietary fatty acids on HIV-infected subjects is lacking.

Objective: Our objective was to investigate the relation between dietary fatty acid intake and liver function in HIV-infected compared with HIV-uninfected subjects.

Design: This cross-sectional epidemiologic survey included a representative sample of 1854 apparently healthy black volunteers aged 15 y, who were recruited from 37 randomly selected sites throughout the North West province of South Africa. Data from 216 asymptomatic HIV-infected and 1604 HIV-uninfected subjects were used.

Results: Intakes of polyunsaturated fatty acids (PUFAs), linoleic acid (n–6), and the ratio of PUFAs to saturated fatty acids (SFAs) were positively associated with all the liver enzymes measured in HIV-infected subjects (R = 0.16–0.65). Most of these R values differed significantly from the R values for HIV-uninfected subjects. No associations were seen between liver enzymes and intakes of SFAs and monounsaturated fatty acids. Vitamin E intake was positively associated with serum -glutamyl transpeptidase (R = 0.23), alanine aminotransferase (R = 0.37), and aspartate aminotransferase (R = 0.58) in HIV-infected subjects; these correlations differed significantly from those of the HIV-uninfected subjects because PUFA sources are the main carriers of vitamin E.

Conclusions: The results suggest that n–6 PUFA intakes may be related to liver damage in these HIV-infected asymptomatic subjects. The reasons or mechanisms responsible are not clear, and further research is necessary to determine the optimal safe amounts for intake of n–6 PUFAs by HIV-infected subjects, especially in countries with traditionally high intakes of n–6 PUFA–rich vegetable oils.

Key Words: Polyunsaturated fatty acids • HIV • liver enzymes • THUSA study

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