Differences in Neurocognitive Impairment Among HIV-Infected Latinos in the United States.

TitleDifferences in Neurocognitive Impairment Among HIV-Infected Latinos in the United States.
Publication TypeJournal Article
Year of Publication2018
AuthorsMarquine, MJ, Heaton, A, Johnson, N, Rivera-Mindt, M, Cherner, M, Bloss, C, Hulgan, T, Umlauf, A, Moore, DJ, Fazeli, P, Morgello, S, Franklin, D, Letendre, S, Ellis, R, Collier, AC, Marra, CM, Clifford, DB, Gelman, BB, Sacktor, N, Simpson, D, J McCutchan, A, Grant, I, Heaton, RK
JournalJ Int Neuropsychol Soc
Date Published2018 02
KeywordsAdult, Cognitive Dysfunction, European Continental Ancestry Group, Executive function, Female, Hispanic Americans, HIV Infections, Humans, Learning, Male, Mexico, Psychomotor Performance, Puerto Rico, United States, Young Adult

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).

Alternate JournalJ Int Neuropsychol Soc
PubMed ID28874213
PubMed Central IDPMC5777885
Grant ListK24 MH097673 / MH / NIMH NIH HHS / United States
U24 MH100928 / MH / NIMH NIH HHS / United States
P30 MH062512 / MH / NIMH NIH HHS / United States
N01 MH022005 / MH / NIMH NIH HHS / United States
K23 MH105297 / MH / NIMH NIH HHS / United States
K24 DA040550 / DA / NIDA NIH HHS / United States
R00 AG048762 / AG / NIA NIH HHS / United States
HHSN271201000030C / MH / NIMH NIH HHS / United States
R25 MH081482 / MH / NIMH NIH HHS / United States
HHSN271201000036C / MH / NIMH NIH HHS / United States
R01 MH107345 / MH / NIMH NIH HHS / United States
U24 MH100930 / MH / NIMH NIH HHS / United States