TY - JOUR
T1 - Ethnic/Racial Disparities in Longitudinal Neurocognitive Decline in People With HIV
AU - Wei-Ming Watson, Caitlin
AU - Kamalyan, Lily
AU - Tang, Bin
AU - Hussain, Mariam A.
AU - Cherner, Mariana
AU - Rivera Mindt, Monica
AU - Byrd, Desiree A.
AU - Franklin, Donald R.
AU - Collier, Ann C.
AU - Clifford, David B.
AU - Gelman, Benjamin
AU - Morgello, Susan
AU - McCutchan, John Allen
AU - Ellis, Ronald J.
AU - Grant, Igor
AU - Heaton, Robert K.
AU - Marquine, María J.
N1 - Funding Information:
The CNS HIV Anti-Retroviral Therapy Effects Research was supported by NIH awards N01 MH22005, HHSN271201000036C, HHSN271201000030C and R01 MH107345. Other support include the following NIH grants: T32-DA031098 (C.W.-M.W., M.A.H.), T32 AA013525 (L.K.), K23MH105297 (M.J.M.), and P30AG059299 (M.J.M).
Publisher Copyright:
© 2022 Lippincott Williams and Wilkins. All rights reserved.
PY - 2022/5/1
Y1 - 2022/5/1
N2 - Background:To examine longitudinal neurocognitive decline among Latino, non-Latino Black, and non-Latino White people with HIV (PWH) and factors that may explain ethnic/racial disparities in neurocognitive decline.Methods:Four hundred ninety nine PWH (13.8% Latino, 42.7% Black, 43.5% White; baseline age: M = 43.5) from the CNS HIV Anti-Retroviral Therapy Effects Research (CHARTER) study completed neurocognitive, neuromedical, and laboratory assessments every 6-12 months with up to 5 years of follow-up. Longitudinal neurocognitive change was determined via published regression-based norms. Survival analyses investigated the relationship between ethnicity/race and neurocognitive change, and baseline and time-dependent variables that may explain ethnic/racial disparities in neurocognitive decline, including socio-demographic, HIV-disease, medical, psychiatric, and substance use characteristics.Results:In Cox proportional hazard models, hazard ratios for neurocognitive decline were increased for Latino compared with White PWH (HR = 2.25, 95% CI = 1.35 to 3.73, P = 0.002), and Latino compared with Black PWH (HR = 1.86, 95% CI = 1.14 to 3.04, P = 0.013), with no significant differences between Black and White PWH (P = 0.40). Comorbidities, including cardiometabolic factors and more severe neurocognitive comorbidity classification, accounted for 33.6% of the excess hazard for Latino compared with White PWH, decreasing the hazard ratio associated with Latino ethnicity (HR = 1.83, 95% CI = 1.06 to 3.16, P = 0.03), but did not fully account for elevated risk of decline.Conclusions:Latino PWH may be at higher risk of early neurocognitive decline compared with Black and White PWH. Comorbidities accounted for some, but not all, of this increased risk among Latino PWH. Future research examining institutional, sociocultural, and biomedical factors, including structural discrimination and age-related biomarkers, may further explain the observed disparities.
AB - Background:To examine longitudinal neurocognitive decline among Latino, non-Latino Black, and non-Latino White people with HIV (PWH) and factors that may explain ethnic/racial disparities in neurocognitive decline.Methods:Four hundred ninety nine PWH (13.8% Latino, 42.7% Black, 43.5% White; baseline age: M = 43.5) from the CNS HIV Anti-Retroviral Therapy Effects Research (CHARTER) study completed neurocognitive, neuromedical, and laboratory assessments every 6-12 months with up to 5 years of follow-up. Longitudinal neurocognitive change was determined via published regression-based norms. Survival analyses investigated the relationship between ethnicity/race and neurocognitive change, and baseline and time-dependent variables that may explain ethnic/racial disparities in neurocognitive decline, including socio-demographic, HIV-disease, medical, psychiatric, and substance use characteristics.Results:In Cox proportional hazard models, hazard ratios for neurocognitive decline were increased for Latino compared with White PWH (HR = 2.25, 95% CI = 1.35 to 3.73, P = 0.002), and Latino compared with Black PWH (HR = 1.86, 95% CI = 1.14 to 3.04, P = 0.013), with no significant differences between Black and White PWH (P = 0.40). Comorbidities, including cardiometabolic factors and more severe neurocognitive comorbidity classification, accounted for 33.6% of the excess hazard for Latino compared with White PWH, decreasing the hazard ratio associated with Latino ethnicity (HR = 1.83, 95% CI = 1.06 to 3.16, P = 0.03), but did not fully account for elevated risk of decline.Conclusions:Latino PWH may be at higher risk of early neurocognitive decline compared with Black and White PWH. Comorbidities accounted for some, but not all, of this increased risk among Latino PWH. Future research examining institutional, sociocultural, and biomedical factors, including structural discrimination and age-related biomarkers, may further explain the observed disparities.
KW - African Americans
KW - Hispanic Americans
KW - cognitive disorders
KW - health status disparities
UR - http://www.scopus.com/inward/record.url?scp=85128245930&partnerID=8YFLogxK
U2 - 10.1097/QAI.0000000000002922
DO - 10.1097/QAI.0000000000002922
M3 - Article
C2 - 35081558
AN - SCOPUS:85128245930
SN - 1525-4135
VL - 90
SP - 97
EP - 105
JO - Journal of acquired immune deficiency syndromes (1999)
JF - Journal of acquired immune deficiency syndromes (1999)
IS - 1
ER -