Hyperlipidaemia related to antiretroviral therapy is a major issue in the management of HIV infection. In HIV positive patients, interventions on their lifestyles and dietary habits are only partially effective and pharmacological support is often required. However, fibrates and statins, interacting with antiretroviral therapy, may cause toxicity. A number of clinical trials have shown the effectiveness of omega-3 fatty acids on the hyperlipidaemia of HIV patients. In this study, the effect of six-month daily administration of omega-3 fatty acids on triglycerides, total and LDL cholesterol, and CD4 cell count was evaluated in a group of 20 HIV positive patients. Triglyceride levels significantly decreased, whilst total, LDL cholesterol and CD4 cell count did not vary. Fish oil therapy was well tolerated by all patients. Omega-3 fatty acids may contribute to reduce cardiovascular risk in HIV positive patients.