Relationship between Alcohol Use/Abuse, HIV Infection and Neuropsychological Performance in African American Men

Abstract

This study examines the impact of alcohol use and HIV infection on neuropsychological performance in a sample of 497 community-resident African American men. HIV serostatus and alcohol use (during the past 12 months) exerted an interactive effect on psychomotor speed, reaction time, and motor speed, and in general, HIV infected heavy drinkers evidenced significantly poorer performance than other HIV positive subjects. Main effects for HIV serostatus were noted for reaction time, with seronegative men performing better than seropositives. This study examines a sample of men who continue to show increases in HIV infection, however, sample specific issues such as comorbid substance use, past histories of head injury, and lack of data on alcohol abuse and dependence require caution in definitively attributing the findings solely to alcohol and HIV. However, these findings suggest that relatively recent heavy alcohol use may represent a potential risk factor for more rapid or pronounced cognitive decline in HIV positive individuals, and that these patterns may be even more pronounced in persons with comorbid substance use. Relationship between Alcohol Use/Abuse, HIV Infection and Neuropsychological Performance in African American MenNumerous studies to date have investigated the synergistic effects of psychoactive drugs and HIV on disease progression and neuropsychological (NP) functioning (Bornstein et al., 1993;Concha et al., 1992, Durvasula et al., 2000Marder et al., 1992, Selnes et al., 1997. These studies, which have largely examined the independent and interactive effects of heroin and cocaine abuse on NP functioning, have yielded mixed results, and most of these studies have been conducted with injection drug users. No studies have demonstrated any interactive effects between drug use and HIV on NP performance. Some studies have reported no differences between asymptomatic injection drug users and seronegative controls Selnes et al., 1992). Bornstein et al. (1993) noted that neither recency nor severity of drug/alcohol abuse/dependence were associated with NP impairment in HIV infection - however, the drugs of abuse were not clearly specified in their study. To date, few studies have focused on whether HIV and alcohol consumption operate synergistically to produce more marked cognitive impairment in HIV infected samples. This is a noteworthy oversight given the relatively high rates of alcohol abuse and dependence among HIV positive individuals (Boscarino, Avins, Woods, Lindan, Hudes, & Clark, 1995). Alcohol Use and NP PerformanceThe adverse neuropsychological consequences of alcohol abuse and dependence are well documented. Mild to moderate NP deficits have been observed in individuals with histories of alcohol dependence (Oscar-Berman, Shagrin, Evert, & Epstein, 1997;Parsons & Nixon, 1993). Deficits are typically observed in attention, visuospatial functioning, executive functioning, and in learning and memory (Parsons & Nixon, 1993;Rourke & Loberg, 1996). There is a wide spectrum of effects as a fun...

Impact of HIV infection and alcohol on cognition: a review

“…This study illustrates many of the difficulties associated with recruiting groups of participants who differ in their degree and duration of alcohol use but who are otherwise comparable in terms of demographic and other variables that might be expected to influence the performance on standardized cognitive tests. Heavy alcohol use can be associated with a number of medical comorbidities that may influence the pattern and degree of neurocognitive abnormalities, 66 and it is not surprising that the study by Durvasula et al 65 showed that the subjects with the highest level of alcohol use also were significantly more likely to have had a history of closed head injury and loss of consciousness than were the subjects with more modest or no alcohol use. There was also no adjustment for the level of premorbid IQ in this study, which is known to have significant effects on overall levels of neurocognitive performance.…”

“…In a large community sample of 497 African-American men, Durvasula et al 65 examined the effect of alcohol and serostatus on neurocognitive performance. They found that their seropositive participants with the heaviest alcohol use had lower performance in some cognitive domains compared with seropositives who were drinking less alcohol and also compared with seronegative heavy drinkers.…”

Neuropsychological Dysfunction among HIV Infected Drug Abusers

“…They found that alcohol and HIV exerted independent effects on cognitive performance but failed to find an interaction effect. In contrast, Durvasula et al [51], using data from the above referenced AAHP study, did demonstrate an interaction between HIV and alcohol use, with HIV+ heavy drinkers evidencing disproportionately poorer performance on measures of reaction time and motor speed relative to HIV+ subjects who did not drink to excess.…”

Problematic Alcohol Use Among Individuals with HIV: Relations with Everyday Memory Functioning and HIV Symptom Severity

“…drinks/month past 3 years) HIV-infected individuals. Similarly, no differences in verbal or non-verbal memory emerged in a comparison of HIV-infected and HIV-uninfected AfricanAmericans with no drinking and light, moderate and heavy drinking [45]. Finally, no differences in learning and memory were observed in a comparison of HIV positive and HIV negative males with and without a history of alcohol abuse [46].…”