Differences in Neurocognitive Impairment among HIV-Infected Latinos in the United States

María J. Marquine; Anne Heaton; Neco Johnson; Monica Rivera-Mindt; Mariana Cherner; Cinnamon Bloss; Todd Hulgan; Anya Umlauf; David J. Moore; Pariya Fazeli; Susan Morgello; Donald Franklin; Scott Letendre; Ron Ellis; Ann C. Collier; Christina M. Marra; David B. Clifford; Benjamin B. Gelman; Ned Sacktor; David Simpson; J. Allen McCutchan; Igor Grant; Robert K. Heaton

doi:10.1017/S1355617717000832

Differences in Neurocognitive Impairment among HIV-Infected Latinos in the United States

María J. Marquine, Anne Heaton, Neco Johnson, Monica Rivera-Mindt, Mariana Cherner, Cinnamon Bloss, Todd Hulgan, Anya Umlauf, David J. Moore, Pariya Fazeli, Susan Morgello, Donald Franklin, Scott Letendre, Ron Ellis, Ann C. Collier, Christina M. Marra, David B. Clifford, Benjamin B. Gelman, Ned Sacktor, David SimpsonJ. Allen McCutchan, Igor Grant, Robert K. Heaton

School of Medicine

Research output: Contribution to journal › Article › peer-review

16 Scopus citations

Abstract

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).

Original language	English (US)
Pages (from-to)	163-175
Number of pages	13
Journal	Journal of the International Neuropsychological Society
Volume	24
Issue number	2
DOIs	https://doi.org/10.1017/S1355617717000832
State	Published - Feb 1 2018

Keywords

Cognitive function
Culture
Health status disparities
Hispanics
Human immunodeficiency virus
Minority health

ASJC Scopus subject areas

General Neuroscience
Clinical Psychology
Clinical Neurology
Psychiatry and Mental health

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10.1017/S1355617717000832

Cite this

Marquine, M. J., Heaton, A., Johnson, N., Rivera-Mindt, M., Cherner, M., Bloss, C., Hulgan, T., Umlauf, A., Moore, D. J., Fazeli, P., Morgello, S., Franklin, D., Letendre, S., Ellis, R., Collier, A. C., Marra, C. M., Clifford, D. B., Gelman, B. B., Sacktor, N., ... Heaton, R. K. (2018). Differences in Neurocognitive Impairment among HIV-Infected Latinos in the United States. Journal of the International Neuropsychological Society, 24(2), 163-175. https://doi.org/10.1017/S1355617717000832

Marquine, 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, McCutchan, JA, Grant, I & Heaton, RK 2018, 'Differences in Neurocognitive Impairment among HIV-Infected Latinos in the United States', Journal of the International Neuropsychological Society, vol. 24, no. 2, pp. 163-175. https://doi.org/10.1017/S1355617717000832

@article{b2d8938bfb73401da95d0bf8af93b9e9,

title = "Differences in Neurocognitive Impairment among HIV-Infected Latinos in the United States",

abstract = "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).",

keywords = "Cognitive function, Culture, Health status disparities, Hispanics, Human immunodeficiency virus, Minority health",

author = "Marquine, {Mar{\'i}a J.} and Anne Heaton and Neco Johnson and Monica Rivera-Mindt and Mariana Cherner and Cinnamon Bloss and Todd Hulgan and Anya Umlauf and Moore, {David J.} and Pariya Fazeli and Susan Morgello and Donald Franklin and Scott Letendre and Ron Ellis and Collier, {Ann C.} and Marra, {Christina M.} and Clifford, {David B.} and Gelman, {Benjamin B.} and Ned Sacktor and David Simpson and McCutchan, {J. Allen} and Igor Grant and Heaton, {Robert K.}",

note = "Publisher Copyright: Copyright {\textcopyright} The International Neuropsychological Society 2017.",

year = "2018",

month = feb,

day = "1",

doi = "10.1017/S1355617717000832",

language = "English (US)",

volume = "24",

pages = "163--175",

journal = "Journal of the International Neuropsychological Society",

issn = "1355-6177",

publisher = "Cambridge University Press",

number = "2",

}

TY - JOUR

T1 - Differences in Neurocognitive Impairment among HIV-Infected Latinos in the United States

AU - Marquine, María J.

AU - Heaton, Anne

AU - Johnson, Neco

AU - Rivera-Mindt, Monica

AU - Cherner, Mariana

AU - Bloss, Cinnamon

AU - Hulgan, Todd

AU - Umlauf, Anya

AU - Moore, David J.

AU - Fazeli, Pariya

AU - Morgello, Susan

AU - Franklin, Donald

AU - Letendre, Scott

AU - Ellis, Ron

AU - Collier, Ann C.

AU - Marra, Christina M.

AU - Clifford, David B.

AU - Gelman, Benjamin B.

AU - Sacktor, Ned

AU - Simpson, David

AU - McCutchan, J. Allen

AU - Grant, Igor

AU - Heaton, Robert K.

PY - 2018/2/1

Y1 - 2018/2/1

N2 - 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).

AB - 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).

KW - Cognitive function

KW - Culture

KW - Health status disparities

KW - Hispanics

KW - Human immunodeficiency virus

KW - Minority health

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SN - 1355-6177

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JO - Journal of the International Neuropsychological Society

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Differences in Neurocognitive Impairment among HIV-Infected Latinos in the United States

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