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Abstract Details

Association of Inflammation and Neurocognitive Impairment in Older Hispanics Living with HIV
Infectious Disease
S29 - NeuroHIV: Pathophysiology and Clinical Phenotypes (4:03 PM-4:14 PM)
004
Hispanics have an increased risk for HIV-associated NCI1, 2 3, as well as incident mild cognitive impairment and Alzheimer’s dementia compared to non-Hispanic whites4, 5. Yet, factors underlying these disparities are not well understood. Inflammation is often increased in HIV disease, older age, and racial/ethnic minorities, and has been linked to NCI6, 7
We aimed to examine the impact of inflammation on neurocognitive impairment (NCI) among older HIV-infected (HIV+) Hispanics and HIV+ non-Hispanic whites.

We performed a retrospective cross-sectional analysis of 292 HIV+ participants age>=40 (61 Hispanic; 231 non-Hispanic whites) enrolled in UCSD HIV Neurobehavioral Research Program’s studies from 2000 to 2017 (overall cohort: mean age=51.6, SD=8.2, 85% male, 75% on antiretroviral therapy [ART]). Neurocognitive function was measured via a comprehensive neurocognitive battery, and NCI was defined using global deficit scores. Inflammatory biomarkers analyzed included serum CRP, serum sCD14 and CSF sCD14. Covariates examined included HIV disease characteristics. A series of logistic regression models were performed on NCI with terms for biomarkers (individually), ethnicity, and their interaction, adjusting for covariates.

A multivariable logistic regression model on NCI adjusting for significant covariates (nadir CD4, current plasma viral load, ART status) showed a significant CSF sCD14 and ethnicity interaction (p=.04), such that higher CSF sCD14 was associated with NCI among Hispanics (p<0.001), but not among non-Hispanics (p=.14). There were no other significant ethnicity/biomarker interactions.

sCD14 is known to play a role in insulin sensitivity8, thus, our results may be mediated by an increased incidence of metabolic syndrome as well as chronic social stressors that are known to be more prevalent in Hispanics7, 9, 10. Further studies are required to determine factors that mediate the link between inflammation and NCI in HIV, particularly in Hispanics.

Authors/Disclosures
Monica M. Diaz, MD (University of North Carolina at Chapel Hill)
PRESENTER
The institution of Dr. Diaz has received research support from Alzheimer's Association. The institution of Dr. Diaz has received research support from 好色先生. The institution of Dr. Diaz has received research support from Merck. The institution of Dr. Diaz has received research support from CorEvitas. The institution of Dr. Diaz has received research support from Celgene Corporation/Bristol-Myers Squibb. The institution of Dr. Diaz has received research support from Novartis. The institution of Dr. Diaz has received research support from Bodford Family Transverse Myelitis Center Fund.
Ronald J. Ellis, MD, PhD, FAAN (UC San Diego) Dr. Ellis has nothing to disclose.
Jennifer Iudicello No disclosure on file
Robert K Heaton The institution of Robert K Heaton has received research support from NIH. Robert K Heaton has received intellectual property interests from a discovery or technology relating to health care. Robert K Heaton has received intellectual property interests from a discovery or technology relating to health care.
Scott L. Letendre, MD (HNRC, UCSD) The institution of Dr. Letendre has received research support from National Institutes of Health. The institution of Dr. Letendre has received research support from University at Buffalo. Dr. Letendre has received publishing royalties from a publication relating to health care.
Igor Grant, MD (University of California San Diego) No disclosure on file
No disclosure on file