Axion insulators are generally understood as magnetic topological insulators whose Chern-Simons axion coupling term is quantized and equal to $\pi$. Inversion and time reversal, or the composition of either one with a rotation or a translation, are symmetries which protect this invariant. In this work, we focus our attention on the composition of a 2-fold rotation with time reversal, and we show that insulators with this symmetry possess a Z2 invariant arising from Atiyah's real K-theory. We call this invariant the K-theory Kane-Mele invariant due to the similarities it has with the Kane-Mele invariant for systems with time-reversal symmetry. Whenever all Chern numbers vanish, we demonstrate that this invariant is equivalent to the Chern-Simons axion coupling, and in the presence of the inversion symmetry, we show how this invariant could be obtained from the eigenvalues of the inversion operator on its fixed points in momentum space. For the general case of non-trivial Chern numbers, the Chern-Simons axion coupling term incorporates information of the K-theory Kane-Mele invariant as well as information regarding bands with non-trival Chern numbers. An explicit formula in terms of K-theory generators is presented for the Chern-Simons axion coupling term, the relation with the K-theory Kane-Mele invariant is explained, and a formula in terms of eigenvalues of the inversion operator is obtained. Using an effective Hamiltonian model and first-principles calculations, we also show that the occurrence of bulk-band inversion and nontrivial K-theory Kane-Mele invariant index can be observed in axion insulators of the pnictides family. In particular, we demonstrate that NpBi can be classified as an axion insulator due to the detection of additional topological indicators such as the quantum spin Hall effect, gapped surface states, surface quantized anomalous Hall effect, and chiral hinge modes
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