Effect of omega-3 supplementation on metabolic and inflammatory markers in adults with HIV infection: a systematic review and meta-analysis
Abstract
Background: People living with human immunodeficiency virus (HIV) infection frequently exhibit altered lipid profiles and persistent inflammation that contribute to long-term morbidity. Omega-3 fatty acids are commonly recommended in this population, but the magnitude and consistency of their benefits remain uncertain. This study aimed to precisely re-estimate the effects of omega-3 supplementation compared with control on selected metabolic (lipid profile) and inflammatory biomarkers (C-reactive protein, CRP), IL-6, and TNF-α in adults with HIV.
Methods: We searched PubMed/MEDLINE, Web of Science, and Scopus databases from 1965 to September 2025 for randomized trials reporting lipid or inflammatory biomarkers in adults with HIV. Eligible studies included participants aged 18 years or older and provided the exact numeric triplets required for reproduction (N, mean change or endpoint, and SD). Risk of bias was assessed using RoB 2. All analyses, figures, funnel plots, Egger and Begg tests, and subgroup tests were reproduced exactly from the investigator-supplied Stata 17.0. To explore heterogeneity, we conducted subgroup analyses and meta-regression analyses using study-level percentages of male participants and follow-up duration in months extracted from the data sheets; outcomes with fewer than 3 usable studies were not pooled.
Results: Twenty-one trials supplying the exact numeric triplets met the inclusion criteria, representing 1,118 participants in total. The reproduced…
How strong is the evidence?
Evidence Hub reads this as a meta-analysis, done in people. Its evidence level is 1 of 5 (Highest · pooled evidence). Pooled evidence from several studies sits at the top of the evidence pyramid. Reported size: 1,118 participants or records.
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