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Neurobehavioral effects of HIV-1 infection in China and the United States: A pilot study

Published online by Cambridge University Press:  14 August 2007

LUCETTE A. CYSIQUE ,
HUA JIN ,
DONALD R. FRANKLIN ,
ERIN E. MORGAN ,
CHUAN SHI ,
XIN YU ,
ZUNYOU WU ,
MICHAEL J. TAYLOR ,
THOMAS D. MARCOTTE  and
SCOTT LETENDRE
...Show all authors
LUCETTE A. CYSIQUE
Affiliation:
Department of Psychiatry, University of California at San Diego, San Diego, California
HUA JIN
Affiliation:
Department of Psychiatry, University of California at San Diego, San Diego, California VA San Diego Health Care System, San Diego, California
DONALD R. FRANKLIN
Affiliation:
Department of Psychiatry, University of California at San Diego, San Diego, California
ERIN E. MORGAN
Affiliation:
Department of Psychiatry, University of California at San Diego, San Diego, California
CHUAN SHI
Affiliation:
Institute of Mental Health, Peking University, Beijing, China
XIN YU
Affiliation:
Institute of Mental Health, Peking University, Beijing, China
ZUNYOU WU
Affiliation:
National Center for AIDS/STD Control & Prevention (NCAIDS), Peking University, Beijing, China
MICHAEL J. TAYLOR
Affiliation:
Department of Psychiatry, University of California at San Diego, San Diego, California
THOMAS D. MARCOTTE
Affiliation:
Department of Psychiatry, University of California at San Diego, San Diego, California
SCOTT LETENDRE
Affiliation:
Department of Psychiatry, University of California at San Diego, San Diego, California
CHRISTOPHER AKE
Affiliation:
Department of Psychiatry, University of California at San Diego, San Diego, California
IGOR GRANT
Affiliation:
Department of Psychiatry, University of California at San Diego, San Diego, California
ROBERT K. HEATON
Affiliation:
Department of Psychiatry, University of California at San Diego, San Diego, California VA San Diego Health Care System, San Diego, California
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Abstract

The HIV epidemic in China has been increasing exponentially, yet there have been no studies of the neurobehavioral effects of HIV infection in that country. Most neuroAIDS research has been conducted in Western countries using Western neuropsychological (NP) methods, and it is unclear whether these testing methods are appropriate for use in China. Twenty-eight HIV seropositive (HIV+) and twenty-three HIV seronegative (HIV−) individuals with comparable gender, age, and education distributions were recruited in Beijing and the rural Anhui province in China. Thirty-nine HIV+ and thirty-one HIV− individuals were selected from a larger U.S. cohort recruited at the HIV Neurobehavioral Research Center, in San Diego, to be matched to the Chinese sample for age, disease status, and treatment variables. The NP test battery used with the U.S. and China cohorts included instruments widely used to study HIV infection in the United States. It consisted of 14 individual test measures, each assigned to one of seven ability areas thought to be especially vulnerable to effects of HIV on the brain (i.e., verbal fluency, abstraction/executive function, speed of information processing, working memory, learning, delayed recall, and motor function). To explore the cross-cultural equivalence and validity of the NP measures, we compared our Chinese and U.S. samples on the individual tests, as well as mean scaled scores for the total battery and seven ability domains. On each NP test measure, the mean of the Chinese HIV+ group was worse than that of the HIV− group. A series of 2 × 2 analyses of variance involving HIV+ and HIV− groups from both countries revealed highly significant HIV effects on the Global and all Domain mean scaled scores. Country effects appeared on two of the individual ability areas, at least partly due to education differences between the two countries. Importantly, the absence of HIV-by-Country interactions suggests that the NP effects of HIV are similar in the two countries. The NP test battery that was chosen and adapted for use in this study of HIV in China appears to have good cross-cultural equivalence, but appropriate Chinese norms will be needed to identify disease-related impairment in individual Chinese people. To inform the development of such norms, a much larger study of demographic effects will be needed, especially considering the wide range of education in that country. (JINS, 2007, 13, 781–790.)

Keywords

HIV/AIDSNeuropsychological functioningCognitionChinaCross-cultural assessmentEveryday functioning
Type
Research Article
Information
Journal of the International Neuropsychological Society , Volume 13 , Issue 5 , September 2007 , pp. 781 - 790
Copyright
2007 The International Neuropsychological Society

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