{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,4,29]],"date-time":"2026-04-29T08:48:56Z","timestamp":1777452536885,"version":"3.51.4"},"reference-count":35,"publisher":"SAGE Publications","issue":"4","license":[{"start":{"date-parts":[[2013,5,1]],"date-time":"2013-05-01T00:00:00Z","timestamp":1367366400000},"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":["Antiviral Therapy"],"published-print":{"date-parts":[[2013,5]]},"abstract":"\n Background<\/jats:title>\n There is a high incidence of tuberculosis (TB) early after antiretroviral therapy (ART) initiation. This historical cohort study evaluated the association of efavirenz (EFV) compared to nevirapine (NVP) with post-ART TB among patients initiated on first-line ART from 2005 to 2009 in a large, urban HIV clinic in Uganda.<\/jats:p>\n <\/jats:sec>\n \n Methods<\/jats:title>\n \n Hazard ratios (HR) for developing TB were computed using multivariable Cox proportional hazards models with inverse weighting of the probability of being prescribed NVP or EFV (calculated by a multi-variable logistic regression model), stratifying by baseline CD4\n +<\/jats:sup>\n T-cell count. Adjustment for time-updated CD4\n +<\/jats:sup>\n T-cell count, restriction of the analysis to patients remaining in follow-up and a TB-free survival analysis were performed as sensitivity analyses.\n <\/jats:p>\n <\/jats:sec>\n \n Results<\/jats:title>\n \n ART was initiated in 5,797 patients; 66% were women with a mean age of 37 years (sd 9) and a median baseline CD4\n +<\/jats:sup>\n T-cell count of 117 cells\/mm\n 3<\/jats:sup>\n (IQR 43\u2013182). Overall, 60% ( n=3,484) were initiated on NVP and 40% ( n=2,313) on EFV. In the first 2 years of ART, 377 patients developed TB. The use of EFV compared to NVP was independently associated with higher TB incidence in patients with a baseline CD4\n +<\/jats:sup>\n T-cell count <100 cells\/mm\n 3<\/jats:sup>\n (HR 2.05 [95% CI 1.29, 3.27]; P=0.003), but not at higher CD4\n +<\/jats:sup>\n T-cell counts (HR 0.71 [95% CI 0.39, 1.31]; P=0.428). These estimates were robust to all sensitivity analyses.\n <\/jats:p>\n <\/jats:sec>\n \n Conclusions<\/jats:title>\n \n There was a higher incidence of TB in patients with baseline CD4\n +<\/jats:sup>\n T-cell counts <100 cells\/mm\n 3<\/jats:sup>\n initiated on EFV compared to those initiated on NVP. Further research in a trial setting or a larger multisite observational cohort is needed to confirm these findings.\n <\/jats:p>\n <\/jats:sec>","DOI":"10.3851\/imp2525","type":"journal-article","created":{"date-parts":[[2013,2,19]],"date-time":"2013-02-19T13:16:21Z","timestamp":1361279781000},"page":"1-8","update-policy":"https:\/\/doi.org\/10.1177\/sage-journals-update-policy","source":"Crossref","is-referenced-by-count":3,"title":["Risk of Tuberculosis after Antiretroviral Treatment Initiation: A Comparison between Efavirenz and Nevirapine Using Inverse Probability Weighting"],"prefix":"10.1177","volume":"18","author":[{"given":"Sabine M","family":"Hermans","sequence":"first","affiliation":[{"name":"Department of Global Health, Academic Medical Center, University of Amsterdam, Amsterdam Institute for Global Health and Development, Amsterdam, the Netherlands"},{"name":"University Medical Center Utrecht, Department of Internal Medicine and Infectious Diseases, Utrecht, the Netherlands"},{"name":"Infectious Diseases Institute, Makerere University College of Health Sciences, Kampala, Uganda"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Yukari C","family":"Manabe","sequence":"additional","affiliation":[{"name":"Infectious Diseases Institute, Makerere University College of Health Sciences, Kampala, Uganda"},{"name":"Johns Hopkins University School of Medicine, Department of Medicine, Division of Infectious Diseases, Baltimore, MD, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Agnes N","family":"Kiragga","sequence":"additional","affiliation":[{"name":"Infectious Diseases Institute, Makerere University College of Health Sciences, Kampala, Uganda"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Andy IM","family":"Hoepelman","sequence":"additional","affiliation":[{"name":"University Medical Center Utrecht, Department of Internal Medicine and Infectious Diseases, Utrecht, the Netherlands"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Joep MA","family":"Lange","sequence":"additional","affiliation":[{"name":"Department of Global Health, Academic Medical Center, University of Amsterdam, Amsterdam Institute for Global Health and Development, Amsterdam, the Netherlands"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Frank","family":"Van Leth","sequence":"additional","affiliation":[{"name":"Department of Global Health, Academic Medical Center, University of Amsterdam, Amsterdam Institute for Global Health and Development, Amsterdam, the Netherlands"},{"name":"KNCV Tuberculosis Foundation, The Hague, the Netherlands"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"179","published-online":{"date-parts":[[2013,5,1]]},"reference":[{"key":"bibr1-IMP2525","doi-asserted-by":"publisher","DOI":"10.1001\/archinte.163.9.1009"},{"key":"bibr2-IMP2525","doi-asserted-by":"publisher","DOI":"10.1016\/S1473-3099(10)70078-5"},{"key":"bibr3-IMP2525","doi-asserted-by":"publisher","DOI":"10.1097\/01.aids.0000194808.20035.c1"},{"key":"bibr4-IMP2525","doi-asserted-by":"publisher","DOI":"10.1086\/595985"},{"key":"bibr5-IMP2525","doi-asserted-by":"publisher","DOI":"10.1097\/QAD.0b013e32832d3b6d"},{"key":"bibr6-IMP2525","doi-asserted-by":"publisher","DOI":"10.5588\/ijtld.10.0249"},{"key":"bibr7-IMP2525","doi-asserted-by":"publisher","DOI":"10.1097\/QAI.0b013e318218a713"},{"key":"bibr8-IMP2525","volume-title":"Antiretroviral therapy for HIV infection in adults and adolescents.","author":"World Health Organization.","year":"2010"},{"key":"bibr9-IMP2525","doi-asserted-by":"publisher","DOI":"10.1086\/498315"},{"key":"bibr10-IMP2525","doi-asserted-by":"publisher","DOI":"10.1086\/522986"},{"key":"bibr11-IMP2525","doi-asserted-by":"publisher","DOI":"10.1093\/infdis\/jir421"},{"key":"bibr12-IMP2525","volume-title":"National antiretroviral treatment and care guidelines for adults, adolescents, and children.","author":"Uganda Ministry of Health","year":"2009"},{"key":"bibr13-IMP2525","volume-title":"Manual of the National Tuberculosis and Leprosy Programme.","author":"Uganda Ministry of Health","year":"2010"},{"key":"bibr14-IMP2525","doi-asserted-by":"publisher","DOI":"10.1371\/journal.pone.0010527"},{"key":"bibr15-IMP2525","doi-asserted-by":"publisher","DOI":"10.1097\/QAI.0b013e318251aeb4"},{"key":"bibr16-IMP2525","doi-asserted-by":"publisher","DOI":"10.1186\/1471-2458-12-674"},{"key":"bibr17-IMP2525","volume-title":"National antiretroviral treatment and care guidelines for adults, adolescents, and children.","author":"Uganda Ministry of Health","year":"2008"},{"key":"bibr18-IMP2525","doi-asserted-by":"publisher","DOI":"10.1097\/QAI.0b013e31814278c0"},{"key":"bibr19-IMP2525","volume-title":"Antiretroviral therapy for HIV Infection in adults and adolescents in resource-limited settings: towards universal access.","author":"World Health Organization.","year":"2006"},{"key":"bibr20-IMP2525","unstructured":"Muwanga A., Easterbrook P., Schaefer P. Losses to follow-up in a large ART program in Uganda.\n Conference of Retroviruses and Opportunistic Infections\n . 3\u20136 February 2008, Boston, MA, USA. Abstract 840."},{"key":"bibr21-IMP2525","doi-asserted-by":"publisher","DOI":"10.1136\/jech.2004.029496"},{"key":"bibr22-IMP2525","doi-asserted-by":"publisher","DOI":"10.1016\/j.trstmh.2012.02.004"},{"key":"bibr23-IMP2525","doi-asserted-by":"publisher","DOI":"10.1080\/01621459.1984.10478078"},{"key":"bibr24-IMP2525","doi-asserted-by":"publisher","DOI":"10.1016\/S0140-6736(04)15997-7"},{"key":"bibr25-IMP2525","first-page":"CD004246","volume":"12","author":"Mbuagbaw L.C.","year":"2010","journal-title":"Cochrane Database Syst Rev"},{"key":"bibr26-IMP2525","doi-asserted-by":"publisher","DOI":"10.1086\/339821"},{"key":"bibr27-IMP2525","doi-asserted-by":"publisher","DOI":"10.1310\/M47B-R51C-X0MC-K3GW"},{"key":"bibr28-IMP2525","doi-asserted-by":"publisher","DOI":"10.1097\/00002030-200201040-00008"},{"key":"bibr29-IMP2525","doi-asserted-by":"publisher","DOI":"10.1097\/QAD.0b013e328310407e"},{"key":"bibr30-IMP2525","doi-asserted-by":"publisher","DOI":"10.1093\/cid\/ciq158"},{"key":"bibr31-IMP2525","doi-asserted-by":"publisher","DOI":"10.1093\/ije\/dym247"},{"key":"bibr32-IMP2525","doi-asserted-by":"publisher","DOI":"10.1073\/pnas.1111825108"},{"key":"bibr33-IMP2525","doi-asserted-by":"publisher","DOI":"10.1073\/pnas.1116513108"},{"key":"bibr34-IMP2525","doi-asserted-by":"publisher","DOI":"10.1021\/tx100186t"},{"key":"bibr35-IMP2525","doi-asserted-by":"publisher","DOI":"10.1371\/journal.pone.0040221"}],"container-title":["Antiviral Therapy"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/journals.sagepub.com\/doi\/pdf\/10.3851\/IMP2525","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/journals.sagepub.com\/doi\/pdf\/10.3851\/IMP2525","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,4,28]],"date-time":"2026-04-28T12:51:21Z","timestamp":1777380681000},"score":1,"resource":{"primary":{"URL":"https:\/\/journals.sagepub.com\/doi\/10.3851\/IMP2525"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2013,5]]},"references-count":35,"journal-issue":{"issue":"4","published-print":{"date-parts":[[2013,5]]}},"alternative-id":["10.3851\/IMP2525"],"URL":"https:\/\/doi.org\/10.3851\/imp2525","relation":{},"ISSN":["1359-6535","2040-2058"],"issn-type":[{"value":"1359-6535","type":"print"},{"value":"2040-2058","type":"electronic"}],"subject":[],"published":{"date-parts":[[2013,5]]}}}