1660. Characterizing HAND in HIV-infected Spanish-speaking Patients
Session: Poster Abstract Session: HIV: Neurological Complications and HAND
Saturday, October 10, 2015
Room: Poster Hall
Posters
  • Poster-HAND2.pdf (221.7 kB)
  • Background: HIV-associated neurocognitive disorder (HAND) continues to be prevalent in the post-HAART era, with prevalence of over 30% in previous studies. Neurocognitive performance may differ between sociodemographic groups, and neurocognitive testing is particularly challenging in monolingual Spanish-speakers. We hypothesized that the proportion of individuals living with neurocognitive impairment (NCI) may be greater in this population.

    Methods: We enrolled 50 HIV-infected monolingual Spanish-speakers. We administered the Trail Making Test (TMT) and the Hopkins Verbal Learning Test-Revised (HVLT-R), both of which are sensitive detecting HAND, and are also normed in Spanish-speakers. Participants were considered to be impaired on these tests if they scored greater than 1 standard deviation below the sociodemographically-adjusted mean (Frascati criteria, 2007). We administered a modified version of the Lawton & Brody Activities of Daily Living Scale and the MOS-HIV Functional/cognitive subscale to assess functional status. We abstracted potential correlates of NCI, including nadir CD4 count and peak HIV viral load. Using univariate and multivariate logistic regression analyses, we examined the relationships between our medical variables, functional status measures, and the presence of impairment on each neurocognitive test, in order to understand correlates of NCI in our sample.

    Results: The proportion of participants demonstrating impairment in executive functioning (TMT-B), learning (HVLT- R), and memory (HVLT-R), were 48%, 56%, and 49%, respectively. Univariate logistic regression analyses revealed peak HIV viral load to be positively associated with impairment in executive functioning [OR = 2.663 (1.104-6.425)]. Subjective functional/cognitive deficits (MOS-HIV) were associated with impairment in both learning and memory [ORs =.847 (.719-.999) and .812 (.684-.963), resp.]

    Conclusion: Rates of NCI in our sample were higher than those estimated for the general US population in previous studies. These neurocognitive deficits were associated with key medical and functional variables, which may represent risk factors for HAND. The results of this pilot study will inform the design of larger studies aiming to develop efficacious HAND screening algorithms for monolingual Spanish-speaking Hispanics living with HIV.

    Gomez Isabel, MD, Infectious Diseases, Jackson Memorial Hospital/University of Miami, Miami, FL, Hector Bolivar, MD, Infectious Diseases, University of Miami/Miami-AIDS Clinical Research Unit, Miami, FL and Julia Seay, PhD, Psychology, University of Miami, Miami, FL

    Disclosures:

    G. Isabel, None

    H. Bolivar, None

    J. Seay, None

    Findings in the abstracts are embargoed until 12:01 a.m. PDT, Wednesday Oct. 7th with the exception of research findings presented at the IDWeek press conferences.