OBJECTIVES: Human immunodeficiency virus (HIV) disproportionately affects Hispanics/Latinos in the United States, yet little is known about neurocognitive impairment (NCI) in this group. We compared the rates of NCI in large well-characterized samples of HIV-infected (HIV+) Latinos and (non-Latino) Whites, and examined HIV-associated NCI among subgroups of Latinos. METHODS: Participants included English-speaking HIV+ adults assessed at six U.S. medical centers (194 Latinos, 600 Whites). For overall group, age: M=42.65 years, SD=8.93; 86% male; education: M=13.17, SD=2.73; 54% had acquired immunodeficiency syndrome. NCI was assessed with a comprehensive test battery with normative corrections for age, education and gender. Covariates examined included HIV-disease characteristics, comorbidities, and genetic ancestry. RESULTS: Compared with Whites, Latinos had higher rates of global NCI (42% vs. 54%), and domain NCI in executive function, learning, recall, working memory, and processing speed. Latinos also fared worse than Whites on current and historical HIV-disease characteristics, and nadir CD4 partially mediated ethnic differences in NCI. Yet, Latinos continued to have more global NCI [odds ratio (OR)=1.59; 95% confidence interval (CI)=1.13-2.23; p<.01] after adjusting for significant covariates. Higher rates of global NCI were observed with Puerto Rican (n=60; 71%) versus Mexican (n=79, 44%) origin/descent; this disparity persisted in models adjusting for significant covariates (OR=2.40; CI=1.11-5.29; p=.03). CONCLUSIONS: HIV+ Latinos, especially of Puerto Rican (vs. Mexican) origin/descent had increased rates of NCI compared with Whites. Differences in rates of NCI were not completely explained by worse HIV-disease characteristics, neurocognitive comorbidities, or genetic ancestry. Future studies should explore culturally relevant psychosocial, biomedical, and genetic factors that might explain these disparities and inform the development of targeted interventions. (JINS, 2018, 24, 163-175).
OBJECTIVES:Human immunodeficiency virus (HIV) disproportionately affects Hispanics/Latinos in the United States, yet little is known about neurocognitive impairment (NCI) in this group. We compared the rates of NCI in large well-characterized samples of HIV-infected (HIV+) Latinos and (non-Latino) Whites, and examined HIV-associated NCI among subgroups of Latinos. METHODS:Participants included English-speaking HIV+ adults assessed at six U.S. medical centers (194 Latinos, 600 Whites). For overall group, age: M=42.65 years, SD=8.93; 86% male; education: M=13.17, SD=2.73; 54% had acquired immunodeficiency syndrome. NCI was assessed with a comprehensive test battery with normative corrections for age, education and gender. Covariates examined included HIV-disease characteristics, comorbidities, and genetic ancestry. RESULTS: Compared with Whites, Latinos had higher rates of global NCI (42% vs. 54%), and domain NCI in executive function, learning, recall, working memory, and processing speed. Latinos also fared worse than Whites on current and historical HIV-disease characteristics, and nadir CD4 partially mediated ethnic differences in NCI. Yet, Latinos continued to have more global NCI [odds ratio (OR)=1.59; 95% confidence interval (CI)=1.13-2.23; p<.01] after adjusting for significant covariates. Higher rates of global NCI were observed with Puerto Rican (n=60; 71%) versus Mexican (n=79, 44%) origin/descent; this disparity persisted in models adjusting for significant covariates (OR=2.40; CI=1.11-5.29; p=.03). CONCLUSIONS:HIV+ Latinos, especially of Puerto Rican (vs. Mexican) origin/descent had increased rates of NCI compared with Whites. Differences in rates of NCI were not completely explained by worse HIV-disease characteristics, neurocognitive comorbidities, or genetic ancestry. Future studies should explore culturally relevant psychosocial, biomedical, and genetic factors that might explain these disparities and inform the development of targeted interventions. (JINS, 2018, 24, 163-175).
Entities:
Keywords:
Cognitive function; Culture; Health status disparities; Hispanics; Human immunodeficiency virus; Minority health
Authors: Catherine L Carey; Steven Paul Woods; Raul Gonzalez; Emily Conover; Thomas D Marcotte; Igor Grant; Robert K Heaton Journal: J Clin Exp Neuropsychol Date: 2004-05 Impact factor: 2.475
Authors: Valerie Wojna; Richard L Skolasky; Rosa Hechavarría; Rául Mayo; Ola Selnes; Justin C McArthur; Loyda M Meléndez; Elizabeth Maldonado; Carmen D Zorrilla; Hermes García; Edmundo Kraiselburd; Avindra Nath Journal: J Neurovirol Date: 2006-10 Impact factor: 2.643
Authors: M F Shapiro; S C Morton; D F McCaffrey; J W Senterfitt; J A Fleishman; J F Perlman; L A Athey; J W Keesey; D P Goldman; S H Berry; S A Bozzette Journal: JAMA Date: 1999 Jun 23-30 Impact factor: 56.272
Authors: R K Heaton; D B Clifford; D R Franklin; S P Woods; C Ake; F Vaida; R J Ellis; S L Letendre; T D Marcotte; J H Atkinson; M Rivera-Mindt; O R Vigil; M J Taylor; A C Collier; C M Marra; B B Gelman; J C McArthur; S Morgello; D M Simpson; J A McCutchan; I Abramson; A Gamst; C Fennema-Notestine; T L Jernigan; J Wong; I Grant Journal: Neurology Date: 2010-12-07 Impact factor: 9.910
Authors: J A McCutchan; J A Marquie-Beck; C A Fitzsimons; S L Letendre; R J Ellis; R K Heaton; T Wolfson; D Rosario; T J Alexander; C Marra; B M Ances; I Grant Journal: Neurology Date: 2012-02-14 Impact factor: 9.910
Authors: Amy C Justice; Matthew S Freiberg; Russ Tracy; Lew Kuller; Janet P Tate; Matthew Bidwell Goetz; David A Fiellin; Gary J Vanasse; Adeel A Butt; Maria C Rodriguez-Barradas; Cynthia Gibert; Kris Ann Oursler; Steven G Deeks; Kendall Bryant Journal: Clin Infect Dis Date: 2012-02-15 Impact factor: 9.079
Authors: Robert K Heaton; Donald R Franklin; Ronald J Ellis; J Allen McCutchan; Scott L Letendre; Shannon Leblanc; Stephanie H Corkran; Nichole A Duarte; David B Clifford; Steven P Woods; Ann C Collier; Christina M Marra; Susan Morgello; Monica Rivera Mindt; Michael J Taylor; Thomas D Marcotte; J Hampton Atkinson; Tanya Wolfson; Benjamin B Gelman; Justin C McArthur; David M Simpson; Ian Abramson; Anthony Gamst; Christine Fennema-Notestine; Terry L Jernigan; Joseph Wong; Igor Grant Journal: J Neurovirol Date: 2010-12-21 Impact factor: 2.643
Authors: Todd Hulgan; Asha R Kallianpur; Yan Guo; Jill S Barnholtz-Sloan; Haley Gittleman; Todd T Brown; Ronald Ellis; Scott Letendre; Robert K Heaton; David C Samuels Journal: J Acquir Immune Defic Syndr Date: 2019-04-01 Impact factor: 3.731
Authors: Jerel Adam Fields; Brian Spencer; Mary Swinton; Emma Martine Qvale; María J Marquine; Arina Alexeeva; Sarah Gough; Benchawanna Soontornniyomkij; Elvira Valera; Eliezer Masliah; Cristian L Achim; Paula Desplats Journal: J Neurochem Date: 2018-11-26 Impact factor: 5.372
Authors: Beverly Yu; Elizabeth Pasipanodya; Jessica L Montoya; Raeanne C Moore; Sara Gianella; Allen McCutchan; Ron Ellis; Robert K Heaton; Dilip V Jeste; David J Moore; María J Marquine Journal: J Acquir Immune Defic Syndr Date: 2019-05-01 Impact factor: 3.731
Authors: Lily Kamalyan; Mariam A Hussain; Monica M Diaz; Anya Umlauf; Donald R Franklin; Mariana Cherner; Monica Rivera Mindt; Lidia Artiola I Fortuny; Igor Grant; Robert K Heaton; María J Marquine Journal: Clin Neuropsychol Date: 2019-12-17 Impact factor: 3.535
Authors: Raha M Dastgheyb; Ned Sacktor; Donald Franklin; Scott Letendre; Thomas Marcotte; Robert Heaton; Igor Grant; Justin C McArthur; Leah H Rubin; Norman J Haughey Journal: J Acquir Immune Defic Syndr Date: 2019-09-01 Impact factor: 3.771
Authors: Drenna Waldrop; Crista Irwin; W Chance Nicholson; Cheryl A Lee; Allison Webel; Pariya L Fazeli; David E Vance Journal: J Assoc Nurses AIDS Care Date: 2021 May-Jun 01 Impact factor: 1.809
Authors: Maral Aghvinian; Emily P Morris; Micah J Savin; Angela C Summers; Cara L Crook; Jordan Stiver; Jairo Gonzalez; Desiree Byrd; Monica Rivera Mindt Journal: J Assoc Nurses AIDS Care Date: 2021-07-08 Impact factor: 1.809