Abstract Details

Title Socioeconomic Status and Cognitive Function in Children with HIV: Evidence from the HIV-Associated Neurocognitive Disorders in Zambia (HANDZ) Study

Topic Global Health and Neuroepidemiology

Presentation(s) P1 - Poster Session 1 (9:00 AM-5:00 PM)

Poster/Presentation
Number 190

Objective To model the relationship between socioeconomic status and cognitive function among children and adolescents with HIV in Zambia

Background Multiple prior studies have identified a detrimental effect of pediatric HIV on cognitive function. Socioeconomic status (SES) is one of the strongest predictors of cognitive performance, and may affect the relationship between HIV and cognition.

Design/Methods As part of the ongoing HIV-Associated Neurocognitive Disorders in Zambia (HANDZ) study, a prospective cohort study, we recruited 208 participants with HIV and 208 HIV-exposed uninfected controls, all aged 8-17 years. A standardized questionnaire was administered to assess SES, and all participants had comprehensive neuropsychological testing. An NPZ8 score was derived as a summary measure of cognitive function. Logistic and linear regression were utilized to model the relationship between SES and cognitive function, and mediation analysis was used to identify specific pathways by which SES may affect cognition.

Results

Children with HIV performed significantly worse on a composite measure of cognitive function (NPZ8 score -0.19 vs. 0.22, p <0.001) and were more likely to have cognitive impairment (33% vs. 19%, p=0.001). Higher SES was associated with reduced risk of cognitive impairment (OR 0.8, 95% CI 0.75-0.92, p<0.001) in both groups, with similar effects in children with HIV and HEU groups. SES was more strongly correlated with NPZ8 score in children with HIV than in uninfected controls (Pearson’s R 0.39 vs 0.28), but predicted NPZ8 in both groups. Mediation analysis suggested that the effect of SES on cognition was most strongly mediated through malnutrition.

Conclusions

Cognitive function is strongly correlated with SES in children with HIV, suggesting a synergistic effect of HIV and poverty on cognitive function.

Authors/Disclosures
Esau G. Mbewe PRESENTER	Esau G. Mbewe has received research support from Research was supported by the National Institute Of Neurological Disorders And Stroke of the National Institutes of Health under Award Number K23NS117310. .
Pelekelo Kabundula	Pelekelo Kabundula has nothing to disclose.
Sylvia Mwanza-Kabaghe	No disclosure on file
Milimo Mweemba	Milimo Mweemba has nothing to disclose.
Alexandra Buda	Ms. Buda has nothing to disclose.
Heather Adams	The institution of Heather Adams has received research support from Current: NIH; Past: Abeona; Batten Research Alliance; American University Centers on Disabilities. An immediate family member of Heather Adams has received publishing royalties from a publication relating to health care. Heather Adams has received personal compensation in the range of $500-$4,999 for serving as a Consultant with Critical Path Institute.
Gretchen L. Birbeck, MD, MPH, DTMH, FAAN (University of Rochester/CHET)	An immediate family member of Dr. Birbeck has received personal compensation in the range of $10,000-$49,999 for serving as an Expert Witness for Various. Dr. Birbeck has a non-compensated relationship as a Ambassador for Zambia with RSTMH that is relevant to AAN interests or activities.
David Bearden, MD (University of Rochester School of Medicine)	Dr. Bearden has received personal compensation in the range of $500-$4,999 for serving as a Consultant for Biogen. Dr. Bearden has received personal compensation in the range of $500-$4,999 for serving as a Consultant for Praxis. Dr. Bearden has received personal compensation in the range of $100,000-$499,999 for serving as an Expert Witness for law firms.

��ɫ��

��ɫ��