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HIV 感染者的神经认知及其在语言和文化多样化队列中的预测因素。

Neurocognition and its predictors in a linguistically and culturally diverse cohort of people with HIV.

机构信息

HIV Neurobehavioral Research Program, University of California San Diego, San Diego, CA, USA.

Department of Psychology, University of Texas at Austin, Austin, TX, USA.

出版信息

Clin Neuropsychol. 2024 Nov;38(8):1890-1909. doi: 10.1080/13854046.2024.2319900. Epub 2024 Apr 8.

Abstract

: HIV/AIDS disproportionately affects Black and Latino people in the United States, yet there is a lack of research on predictors of neurocognitive outcomes in these groups. We examined neurocognitive performance and its key predictors across White, Black, and Latino people with HIV (PWH). : Participants included 586 PWH of White, Black, and Latino (English- and Spanish-speaking) background. Neurocognition was assessed demographically-adjusted Fluid Cognition Composite T-scores from the NIH-Toolbox cognition battery, and individual tests comprising this composite. Predictors examined included sociodemographic and HIV disease characteristics, and medical, psychiatric and substance comorbidities. : Compared to White PWH, English-speaking Latino PWH had lower T-scores on the Fluid Cognition Composite, as well as Flanker Inhibition and Picture Sequence Memory tests. While there were no other significant group differences on Fluid Cognition, both Latino PWH language groups performed worse than Black PWH on Flanker Inhibition, and Black PWH performed worse than White PWH on List Sorting. Separate multivariable linear regression models by ethnic/racial/language group showed that significant correlates of worse Fluid Cognition included depressive symptoms among White PWH; hepatitis C co-infection among Black PWH; hypertension among English-speaking Latino PWH; and higher estimated duration of HIV disease and depressive symptoms in Spanish-speaking Latino PWH. : Findings suggest worse neurocognition among English-speaking Latino PWH compared to Whites. Predictors of neurocognitive function among PWH differ across ethnic/racial and language groups. Consideration of these HIV disease characteristics and comorbidities may be valuable in developing targeted culturally-relevant interventions aimed at ameliorating neurocognitive dysfunction among diverse PWH.

摘要

:艾滋病毒/艾滋病在美国不成比例地影响黑人和拉丁裔人群,但针对这些人群神经认知结果的预测因素的研究却很少。我们研究了美国艾滋病毒感染者(PWH)中白种人、黑人和拉丁裔人群的神经认知表现及其主要预测因素。

:参与者包括 586 名白种人、黑人和拉丁裔(英语和西班牙语)背景的 PWH。神经认知是通过 NIH-Toolbox 认知电池的人口统计学调整后的流体认知综合 T 评分以及构成该综合的个体测试来评估的。检查的预测因素包括社会人口统计学和艾滋病毒疾病特征以及医疗、精神和物质合并症。

:与白人 PWH 相比,讲英语的拉丁裔 PWH 的流体认知综合 T 评分以及侧翼抑制和图片序列记忆测试得分较低。虽然在流体认知方面没有其他显著的组间差异,但讲西班牙语的拉丁裔 PWH 在侧翼抑制方面的表现均不如黑人和白人 PWH,而黑人和白人 PWH 在列表排序方面的表现均不如白人 PWH。按族裔/种族/语言群体划分的单独多变量线性回归模型显示,流体认知较差的显著相关因素包括白人 PWH 的抑郁症状;黑人和 PWH 的丙型肝炎合并感染;讲英语的拉丁裔 PWH 的高血压;以及西班牙语拉丁裔 PWH 中 HIV 疾病和抑郁症状的估计持续时间较长。

:研究结果表明,与白人相比,讲英语的拉丁裔 PWH 的神经认知能力较差。PWH 神经认知功能的预测因素因族裔/种族和语言群体而异。考虑到这些 HIV 疾病特征和合并症,可能有助于制定针对不同 PWH 的文化相关干预措施,以改善神经认知功能障碍。

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