{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,5,4]],"date-time":"2026-05-04T20:36:29Z","timestamp":1777926989368,"version":"3.51.4"},"reference-count":36,"publisher":"SAGE Publications","issue":"4","license":[{"start":{"date-parts":[[2013,4,1]],"date-time":"2013-04-01T00:00:00Z","timestamp":1364774400000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/journals.sagepub.com\/page\/policies\/text-and-data-mining-license"}],"content-domain":{"domain":["journals.sagepub.com"],"crossmark-restriction":true},"short-container-title":["Int J STD AIDS"],"published-print":{"date-parts":[[2013,4]]},"abstract":"<jats:p>Summary<\/jats:p>\n                  <jats:p>Management of tuberculosis (TB)-HIV co-infection is complicated by interactions between the diseases and their therapies. We developed and evaluated a strategy to (i) treat co-infected patients in a single co-infection clinic, (ii) maximize use of first-line drugs, (iii) delay antiretroviral therapy (ART) until two months post-TB treatment except in severe immunosuppression, (iv) commence efavirenz at 600 mg daily with therapeutic drug monitoring (TDM) and (v) target treatment completion. We conducted a prospective cohort review over 5.5 years in a UK tertiary referral center where 56 HIV-positive patients treated for TB were followed-up for a median 30 months. Main outcome measures were treatment completion, adverse events, immune reconstitution inflammatory syndrome, immunological and virological parameters, and TDM for efavirenz. Treatment completion rates were 88% (49\/56); four patients were lost to local follow-up and three (5.4%) died during treatment; no deaths were TB-related. Adverse events were common (55%), but caused no treatment interruptions. Standard doses (600 mg daily) of efavirenz with rifampicin achieved or exceeded therapeutic levels in 25\/28 (89%). This study supports combined management for TB\u2013HIV co-infected patients. Delaying ART to two months post-TB treatment did not seem to result in poor clinical outcomes in this well-resourced context. Although efavirenz 600 mg daily usually achieved satisfactory levels, TDM is recommended.<\/jats:p>","DOI":"10.1177\/0956462412472431","type":"journal-article","created":{"date-parts":[[2013,5,3]],"date-time":"2013-05-03T17:01:09Z","timestamp":1367600469000},"page":"263-268","update-policy":"https:\/\/doi.org\/10.1177\/sage-journals-update-policy","source":"Crossref","is-referenced-by-count":1,"title":["Evaluation of a pro-active strategy for managing tuberculosis\u2013HIV co-infection in a UK tertiary care setting"],"prefix":"10.1177","volume":"24","author":[{"given":"R M","family":"Wake","sequence":"first","affiliation":[{"name":"Infection & Immunity Research Centre, St George's, University of London, Cranmer Terrace, London SW17 0RE, UK"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"P","family":"Poulikakos","sequence":"additional","affiliation":[{"name":"Infection & Immunity Research Centre, St George's, University of London, Cranmer Terrace, London SW17 0RE, UK"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"J","family":"Groth","sequence":"additional","affiliation":[{"name":"Chest Clinic"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"T S","family":"Harrison","sequence":"additional","affiliation":[{"name":"Infection & Immunity Research Centre, St George's, University of London, Cranmer Terrace, London SW17 0RE, UK"},{"name":"Clinical Infection Unit, St George's Healthcare NHS Trust London SW17 0QT, UK"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"D C","family":"Macallan","sequence":"additional","affiliation":[{"name":"Infection & Immunity Research Centre, St George's, University of London, Cranmer Terrace, London SW17 0RE, UK"},{"name":"Clinical Infection Unit, St George's Healthcare NHS Trust London SW17 0QT, UK"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"179","published-online":{"date-parts":[[2013,4,1]]},"reference":[{"key":"bibr1-0956462412472431","volume-title":"Interim Policy on Collaborative TB\/HIV Activities","author":"Getahun H","year":"2004"},{"key":"bibr2-0956462412472431","doi-asserted-by":"publisher","DOI":"10.1111\/j.1468-1293.2005.00293.x"},{"key":"bibr3-0956462412472431","doi-asserted-by":"publisher","DOI":"10.1001\/archinte.163.9.1009"},{"key":"bibr4-0956462412472431","doi-asserted-by":"publisher","DOI":"10.1046\/j.1365-2249.2001.01401.x"},{"key":"bibr5-0956462412472431","doi-asserted-by":"publisher","DOI":"10.1097\/00002030-200201040-00010"},{"key":"bibr6-0956462412472431","doi-asserted-by":"publisher","DOI":"10.1097\/QAD.0b013e328011efac"},{"key":"bibr7-0956462412472431","doi-asserted-by":"publisher","DOI":"10.1186\/1742-6405-4-9"},{"key":"bibr8-0956462412472431","doi-asserted-by":"publisher","DOI":"10.1164\/ajrccm.158.1.9712001"},{"key":"bibr9-0956462412472431","first-page":"1","volume":"58","author":"Kaplan JE","year":"2009","journal-title":"MMWR"},{"key":"bibr10-0956462412472431","doi-asserted-by":"publisher","DOI":"10.1097\/01.aids.0000238406.93249.cd"},{"key":"bibr11-0956462412472431","doi-asserted-by":"publisher","DOI":"10.1056\/NEJMoa1013911"},{"key":"bibr12-0956462412472431","doi-asserted-by":"publisher","DOI":"10.1056\/NEJMoa0905848"},{"key":"bibr13-0956462412472431","doi-asserted-by":"publisher","DOI":"10.1056\/NEJMoa1014181"},{"key":"bibr14-0956462412472431","doi-asserted-by":"publisher","DOI":"10.1056\/NEJMoa1013607"},{"key":"bibr15-0956462412472431","doi-asserted-by":"publisher","DOI":"10.1111\/j.1468-1293.2011.00954.x"},{"key":"bibr16-0956462412472431","volume-title":"Tuberculosis. 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