{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,6,12]],"date-time":"2026-06-12T11:57:29Z","timestamp":1781265449984,"version":"3.54.1"},"reference-count":51,"publisher":"FapUNIFESP (SciELO)","license":[{"start":{"date-parts":[[2026,1,1]],"date-time":"2026-01-01T00:00:00Z","timestamp":1767225600000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"},{"start":{"date-parts":[[2026,1,1]],"date-time":"2026-01-01T00:00:00Z","timestamp":1767225600000},"content-version":"am","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"},{"start":{"date-parts":[[2026,1,1]],"date-time":"2026-01-01T00:00:00Z","timestamp":1767225600000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"name":"DECIT\/SCTIE\/MS","award":["25029.000507\/2013-07"],"award-info":[{"award-number":["25029.000507\/2013-07"]}]},{"name":"DECIT\/SCTIE\/MS","award":["U01 AI069923"],"award-info":[{"award-number":["U01 AI069923"]}]},{"name":"DECIT\/SCTIE\/MS","award":["R01 A1120790"],"award-info":[{"award-number":["R01 A1120790"]}]},{"name":"DECIT\/SCTIE\/MS","award":["F31 AI152614"],"award-info":[{"award-number":["F31 AI152614"]}]},{"name":"DECIT\/SCTIE\/MS","award":["Finance Code 001"],"award-info":[{"award-number":["Finance Code 001"]}]},{"name":"DECIT\/SCTIE\/MS","award":["CAPES-PrInt 88887.694717\/2022-00"],"award-info":[{"award-number":["CAPES-PrInt 88887.694717\/2022-00"]}]},{"name":"NIH\/NIAID","award":["25029.000507\/2013-07"],"award-info":[{"award-number":["25029.000507\/2013-07"]}]},{"name":"NIH\/NIAID","award":["U01 AI069923"],"award-info":[{"award-number":["U01 AI069923"]}]},{"name":"NIH\/NIAID","award":["R01 A1120790"],"award-info":[{"award-number":["R01 A1120790"]}]},{"name":"NIH\/NIAID","award":["F31 AI152614"],"award-info":[{"award-number":["F31 AI152614"]}]},{"name":"NIH\/NIAID","award":["Finance Code 001"],"award-info":[{"award-number":["Finance Code 001"]}]},{"name":"NIH\/NIAID","award":["CAPES-PrInt 88887.694717\/2022-00"],"award-info":[{"award-number":["CAPES-PrInt 88887.694717\/2022-00"]}]},{"DOI":"10.13039\/501100002322","name":"CAPES","doi-asserted-by":"crossref","award":["25029.000507\/2013-07"],"award-info":[{"award-number":["25029.000507\/2013-07"]}],"id":[{"id":"10.13039\/501100002322","id-type":"DOI","asserted-by":"crossref"}]},{"DOI":"10.13039\/501100002322","name":"CAPES","doi-asserted-by":"crossref","award":["U01 AI069923"],"award-info":[{"award-number":["U01 AI069923"]}],"id":[{"id":"10.13039\/501100002322","id-type":"DOI","asserted-by":"crossref"}]},{"DOI":"10.13039\/501100002322","name":"CAPES","doi-asserted-by":"crossref","award":["R01 A1120790"],"award-info":[{"award-number":["R01 A1120790"]}],"id":[{"id":"10.13039\/501100002322","id-type":"DOI","asserted-by":"crossref"}]},{"DOI":"10.13039\/501100002322","name":"CAPES","doi-asserted-by":"crossref","award":["F31 AI152614"],"award-info":[{"award-number":["F31 AI152614"]}],"id":[{"id":"10.13039\/501100002322","id-type":"DOI","asserted-by":"crossref"}]},{"DOI":"10.13039\/501100002322","name":"CAPES","doi-asserted-by":"crossref","award":["Finance Code 001"],"award-info":[{"award-number":["Finance Code 001"]}],"id":[{"id":"10.13039\/501100002322","id-type":"DOI","asserted-by":"crossref"}]},{"DOI":"10.13039\/501100002322","name":"CAPES","doi-asserted-by":"crossref","award":["CAPES-PrInt 88887.694717\/2022-00"],"award-info":[{"award-number":["CAPES-PrInt 88887.694717\/2022-00"]}],"id":[{"id":"10.13039\/501100002322","id-type":"DOI","asserted-by":"crossref"}]}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Mem. Inst. Oswaldo Cruz"],"abstract":"<jats:p>BACKGROUND Tuberculosis\/human immunodeficiency virus (TB\/HIV) coinfection is associated with advanced HIV disease and variable responses to antiretroviral therapy (ART).  OBJECTIVES We examined whether baseline HIV severity markers, ART regimes, or human genetic variants influenced HIV-1 virologic suppression in HIV-associated TB.  METHODS We included TB\/HIV participants from Regional Prospective Observational Research in Tuberculosis (RePORT)-Brazil study, who received standard TB therapy and antiretroviral treatment. The primary endpoint was HIV-1 virologic suppression (\u2264 1,000 copies\/mL); Baseline characteristics, viral load (VL), CD4 cell count, timing of ART initiation, and ART regimens were included. We genotyped UGT1A1 (rs887829; integrase strand transfer inhibitor-related) and CYP2B6 [rs3745274, rs28399499, rs4803419; efavirenz (EFZ)-related]; all have defined normal, intermediate, and slow genotypes. Genotyping was performed by MassARRAY iPLEX Gold; Kaplan-Meier curves compared time-to-suppression with log-rank tests; Cox proportional hazards models estimated hazard ratios.  FINDINGS Among 194 participants, 68% (n = 132) achieved virologic suppression (\u2264 1,000 copies\/mL). Median time-to-suppression: 84 days [95% confidence interval (CI): 42-125]. Participants with higher baseline viral load (BVL) (\u2265 5 log10 copies\/mL) had delayed suppression compared with those with lower VL (&lt; 5 log10; log-rank \u03c7\u00b2 = 75.9; p &lt; 0.001). Individuals with CD4 \u2264 200 cells\/\u00b5L suppressed more slowly than those with CD4 &gt; 200 cells\/\u00b5L (log-rank \u03c7\u00b2 = 29.6; p &lt; 0.001). Participants starting ART before TB treatment achieved suppression faster than ART-na\u00efve individuals (32 vs. 147 days; log-rank \u03c7\u00b2 = 48.5; p &lt; 0.001). Higher BVL was associated with reduced hazard of suppression [adjusted hazard ratio (aHR) = 0.67; 95% CI: 0.61-0.75], while higher baseline CD4 count increased the hazard of suppression (per 100 cells\/\u00b5L: aHR = 1.11; 95% CI: 1.01-1.21). ART-na\u00efve status was associated with lower hazard of suppression in univariate analysis (Hazard Ratio = 0.51; 95% CI: 0.36-0.72) but not after adjustment. ART regimen class and pharmacogenetic metabolizer profiles were not significantly associated with virologic suppression.  MAIN CONCLUSIONS BVL and CD4 count were the strongest determinants of virologic suppression in TB\/HIV patients. Suppression rates were low, and neither ART regimen nor pharmacogenetic profiles significantly influenced the likelihood of suppression.<\/jats:p>","DOI":"10.1590\/0074-02760250090","type":"journal-article","created":{"date-parts":[[2026,6,12]],"date-time":"2026-06-12T11:09:58Z","timestamp":1781262598000},"source":"Crossref","is-referenced-by-count":0,"title":["Determinants of HIV-1 virologic suppression in HIV-associated tuberculosis in Brazil"],"prefix":"10.1590","volume":"121","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-3377-1026","authenticated-orcid":false,"given":"Felipe","family":"Ridolfi","sequence":"first","affiliation":[{"name":"Vanderbilt University Medical Center,  USA; Funda\u00e7\u00e3o Oswaldo Cruz-Fiocruz,  Brasil"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Gustavo","family":"Amorim","sequence":"additional","affiliation":[{"name":"Vanderbilt University Medical Center,  USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"David W","family":"Haas","sequence":"additional","affiliation":[{"name":"Vanderbilt University Medical Center,  USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Maria","family":"Arriaga","sequence":"additional","affiliation":[{"name":"Vanderbilt University Medical Center,  USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Cody","family":"Staats","sequence":"additional","affiliation":[{"name":"Vanderbilt University Medical Center,  USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Marcelo","family":"Cordeiro-Santos","sequence":"additional","affiliation":[{"name":"Funda\u00e7\u00e3o Medicina Tropical Dr Heitor Vieira Dourado,  Brasil; Universidade do Estado do Amazonas,  Brasil"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Afr\u00e2nio L","family":"Kritski","sequence":"additional","affiliation":[{"name":"Universidade Federal do Rio de Janeiro,  Brasil"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Marina C","family":"Figueiredo","sequence":"additional","affiliation":[{"name":"Vanderbilt University Medical Center,  USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Bruno B","family":"Andrade","sequence":"additional","affiliation":[{"name":"Multinational Organization Network Sponsoring Translational and Epidemiological Research Initiative,  Brasil; Faculdade de Tecnologia e Ci\u00eancias,  Brasil; Funda\u00e7\u00e3o Oswaldo Cruz-Fiocruz,  Brasil; Universidade Salvador,  Brasil; Escola Bahiana de Medicina e Sa\u00fade P\u00fablica,  Brasil"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Timothy R","family":"Sterling","sequence":"additional","affiliation":[{"name":"Vanderbilt University Medical Center,  USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Valeria C","family":"Rolla","sequence":"additional","affiliation":[{"name":"Funda\u00e7\u00e3o Oswaldo 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Protocolos e Diretrizes. N\u00ba 853. Protocolo cl\u00ednico e diretrizes terap\u00eauticas para manejo da infec\u00e7\u00e3o pelo HIV em adultos. M\u00f3dulo 1: Tratamento","year":"2023"},{"issue":"6","key":"ref44","doi-asserted-by":"crossref","first-page":"459","DOI":"10.1016\/S1473-3099(14)70711-X","article-title":"Raltegravir for the treatment of patients co-infected with HIV and tuberculosis (ANRS 12180 Reflate TB): a multicentre, phase 2, non-comparative, open-label, randomized trial","volume":"14","author":"Grinsztejn B","year":"2014","journal-title":"Lancet Infect Dis"},{"issue":"9","key":"ref45","doi-asserted-by":"crossref","first-page":"1403","DOI":"10.1097\/QAD.0b013e32835f1db0","article-title":"Adverse events associated with nevirapine- and efavirenz-based first-line antiretroviral therapy: a systematic review and meta-analysis","volume":"27","author":"Shubber Z","year":"2013","journal-title":"AIDS"},{"issue":"10","key":"ref46","doi-asserted-by":"crossref","first-page":"e0162775","DOI":"10.1371\/journal.pone.0162775","article-title":"Dolutegravir plus two nucleoside reverse transcriptase inhibitors versus efavirenz plus two nucleoside reverse transcriptase inhibitors as initial antiretroviral therapy for people with HIV: a systematic review","volume":"11","author":"Rutherford GW","year":"2016","journal-title":"PLoS One"},{"issue":"4","key":"ref47","doi-asserted-by":"crossref","first-page":"549","DOI":"10.1093\/cid\/ciz256","article-title":"Dolutegravir-based antiretroviral therapy for patients coinfected with tuberculosis and human immunodeficiency virus: a multicenter, noncomparative, open-label, randomized trial","volume":"70","author":"Dooley KE","year":"2020","journal-title":"Clin Infect Dis"},{"issue":"9","key":"ref48","doi-asserted-by":"crossref","first-page":"816","DOI":"10.1056\/NEJMoa1904340","article-title":"Dolutegravir-based or low-dose efavirenz-based regimen for the treatment of HIV-1","volume":"381","author":"Kouanfack C","year":"2019","journal-title":"N Engl J Med"},{"issue":"16","key":"ref49","doi-asserted-by":"crossref","first-page":"1471","DOI":"10.1056\/NEJMoa1013911","article-title":"Earlier versus later start of antiretroviral therapy in HIV-infected adults with tuberculosis","volume":"365","author":"Blanc FX","year":"2011","journal-title":"N Engl J Med"},{"issue":"6","key":"ref50","first-page":"e40139","article-title":"Treatment outcomes of dolutegravir- versus efavirenz-based highly active antiretroviral therapy regimens among treatment-naive people living with HIV","volume":"15","author":"Mahale PR","year":"2023","journal-title":"Cureus"},{"key":"ref51","doi-asserted-by":"crossref","first-page":"eAO0156","DOI":"10.31744\/einstein_journal\/2023AO0156","article-title":"Suppression of HIV in the first 12 months of antiretroviral therapy: a comparative analysis of dolutegravir- and efavirenz-based regimens","volume":"21","author":"Silva GJ","year":"2023","journal-title":"Einstein (S\u00e3o Paulo)"}],"container-title":["Mem\u00f3rias do Instituto Oswaldo Cruz"],"original-title":[],"link":[{"URL":"http:\/\/www.scielo.br\/scielo.php?script=sci_pdf&pid=S0074-02762026000105037&tlng=en","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,6,12]],"date-time":"2026-06-12T11:10:07Z","timestamp":1781262607000},"score":1,"resource":{"primary":{"URL":"http:\/\/www.scielo.br\/scielo.php?script=sci_arttext&pid=S0074-02762026000105037&tlng=en"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2026]]},"references-count":51,"alternative-id":["S0074-02762026000105037"],"URL":"https:\/\/doi.org\/10.1590\/0074-02760250090","relation":{},"ISSN":["1678-8060","0074-0276"],"issn-type":[{"value":"1678-8060","type":"electronic"},{"value":"0074-0276","type":"print"}],"subject":[],"published":{"date-parts":[[2026]]},"article-number":"e250090"}}