The purpose of this study is to determine whether fish oil supplementation with Lovaza, formally known as Omacor will result in a significant reduction in serum triglyceride (TG), an increase in high density lipoproteins(HDL), and an improvement of endothelial dysfunction.

This is a randomized, double blind, placebo controlled, cross-over, clinical trial to determine the effect of fish oil supplementation with Lovaza® on triglyceride levels in HIV-infected subjects on HAART with elevated serum triglycerides. The sample size is 40 subjects. The total duration of the study is 28 weeks, with 12-week treatment periods separated by a 4-week washout. This study will be conducted at the Clinical Research Center at Tufts Medical Center.

Inclusion Criteria:

• HIV-infected men and women at least 18 years of age
• On stable HAART for previous three months and without anticipated changes in their HAART regimen throughout the duration of the study
• Fasting triglycerides > 150 mg/dl and < 1,500 mg/dl
• Participants may be on lipid lowering therapy; if on lipid lowering therapy, therapy must be stable for 8 weeks and cannot be changes during the course of the study
• Participants may be on beta blockers (e.g., Atenolol, Metoprolol, Propranolol), Estrogens (e.g.,Estinyl;Estrace;Estraderm) and Thiazides (water pills), however therapy with these agents must be stable for 8 weeks before starting the study and cannot be altered while on the study unless deemed medically necessary by the participant's medical provider and approved by Dr. Wanke
• Female participants of reproductive age must not be pregnant (negative test) or lactating at screening and throughout the trial and agree to use 2 methods of barrier contraception for the course of the trial and 2 months after the trial unless they are surgically sterilized (tubal ligation or hysterectomy), or post-menopausal with no menses for > 1 year
• Ability to provide consent

Exclusion Criteria:

• Plasma HIV-1 RNA > 10,000
• Previous history of atherosclerotic disease or diabetes mellitus
• Change in HAART regimen over three months prior to study entry
• Change in lipid lowering therapy within 2 months
• On chronic anticoagulants such as heparin or coumadin
• On fish oil, omega 3 supplements, or Omacor currently or during the past month

AE reporting lasted the duration of the study (28 weeks)

We had low numbers that may not represent the overall population. There was not an HIV negative control arm. The 4 week wash out was too short and therefore difficult to compare the post-treatment vs true post placebo effects.