Comprehensive Assessment of the Impact of Alcohol Use on Cognitive Deficits in People with HIV

Abstract

Human immunodeficiency virus (HIV) infection profoundly impacts the nervous system, leading to neurological deficits such as HIV-associated neurocognitive disorder (HAND). HAND represents the most common neurological comorbidity among people with HIV (PWH), and alcohol use may exacerbate the cognitive deficits seen in this condition, especially in underserved populations. This study aimed to investigate the relationship between alcohol use patterns and cognitive performance in an underserved cohort of PWH, with the hypothesis that alcohol misuse would exacerbate cognitive deficits in this population. Data collected from participants (n=259; 66.7% male; mean age 52 ± 10 years) enrolled in the New Orleans Alcohol Use in HIV (NOAH) study were utilized for cross-sectional analysis. Cognitive function was assessed using the Montreal Cognitive Assessment (MoCA), and alcohol use was comprehensively measured by four metrics: Alcohol Use Disorders Identification Test (AUDIT), 30-day timeline followback (TLFB), lifetime drinking history, and phosphatidylethanol (PEth) levels. The average MoCA score among participants was 20.7 ± 4.5, with 86.5% demonstrating cognitive impairment (MoCA < 26). Notably, individuals with total MoCA scores below 18 (classified as moderately or severely cognitively impaired) had a higher frequency of recent severe alcohol misuse (as assessed by PEth levels) and greater lifetime alcohol consumption. Participants at increased risk for AUD (as assessed by the AUDIT) also had worse global cognition and memory task performance, particularly those aged 50 and older. Further analysis of MoCA sub-score data indicated that participants with increased AUD risk had significant impairments in the cognitive domains of language, delayed recall, and memory. These findings highlight the importance of considering alcohol use and AUD risk as important factors that may exacerbate cognitive decline in vulnerable populations, including older patients and PWH. Future analyses will compare the relationship between cognition and alcohol in these HIV-positive patients with a cohort of HIV-negative patients to better understand the impact of concurrent HIV and alcohol misuse on cognitive function. This research was supported by grant #F30AA030941, #T32AA007577, and #P60AA009803 from the NIAAA at the National Institutes of Health. This is the full abstract presented at the American Physiology Summit 2024 meeting and is only available in HTML format. There are no additional versions or additional content available for this abstract. Physiology was not involved in the peer review process.