Observational studyMedicine2016
Risk Factors for Incident Diabetes in a Cohort Taking First-Line Nonnucleoside Reverse Transcriptase Inhibitor-Based Antiretroviral Therapy.
Observational study in Medicine, 2016. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 32 papers, 4 of them syntheses that pooled it.
What it found
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The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.
Who cites it
32 citing papers in PubMed, 4 syntheses or guidelines pooled it, 61 citations in OpenAlex.
- Diabetes risk in HIV infection and antiretroviral therapy: A systematic review and meta-analysis of prospective cohort evidence.HIV medicine · 2026Pooled it
- A systematic review assessing body mass index and waist circumference as predictors for the development of type 2 diabetes mellitus among people living with HIV on antiretroviral therapy.BMC infectious diseases · 2025Pooled it
- Noncommunicable diseases among HIV-infected persons in low-income and middle-income countries: a systematic review and meta-analysis.AIDS (London, England) · 2018Pooled it
- Incidence and prevalence of type 2 diabetes mellitus with HIV infection in Africa: a systematic review and meta-analysis.BMJ open · 2017Pooled it
- Efficacy and Safety of Tenofovir Disoproxil Fumarate Versus Low-Dose Stavudine Over 96 Weeks: A Multicountry Randomized, Noninferiority Trial.Journal of acquired immune deficiency syndromes (1999) · 2019Trial
- Type 2 diabetes in people living with HIV: epidemiology, mechanisms, sex differences and early-life determinants.Frontiers in endocrinology · 2026Review
- Metabolic impact of switching from EFV/TDF/FTC to two INSTI-Based regimens (B/F/TAF vs. DTG/3TC): a real-world study in virologically suppressed individuals.Frontiers in pharmacology · 2026Article
- A model-based approach to estimating the prevalence of disease combinations in South Africa.BMJ global health · 2024Article
- Glucose metabolism continuous deteriorating in male patients with human immunodeficiency virus accepted antiretroviral therapy for 156 weeks.World journal of diabetes · 2023Article
- Development of Hypertension and Diabetes Mellitus, and Associated Factors, Among Adult HIV Patients in Ethiopia.HIV/AIDS (Auckland, N.Z.) · 2023Article
- Association of Cumulative Viral Load With the Incidence of Hypertension and Diabetes in People With HIV.Hypertension (Dallas, Tex. : 1979) · 2022Article
- When therapeutic drugs lead to diabetes.Diabetologia · 2022Review
- The prevalence of hyperglycemia and its impact on mortality among people living with HIV in Georgia.PloS one · 2022Article
- The cardiometabolic profile and related dietary intake of Ugandans living with HIV and AIDS.Frontiers in nutrition · 2022Article
- Distinct patterns of fasting plasma glucose and lipid profile levels over time in adults tested positive for HIV on HAART in Shanghai, China, revealed using growth mixture models.Frontiers in medicine · 2022Article
- Prevalence and predictors of glucose metabolism disorders among People Living with HIV on combination antiretroviral therapy.PloS one · 2022Article
- Gradual increasing dyslipidemia in treatment-naive male patients with human immunodeficiency virus and treated with tenofovir plus lamivudine plus efavirenz for 3 years.Diabetology & metabolic syndrome · 2021Article
- Gestational diabetes in women living with HIV in Botswana: lower rates with dolutegravir- than with efavirenz-based antiretroviral therapy.HIV medicine · 2021Article
- The treatment gap for mental disorders in adults enrolled in HIV treatment programmes in South Africa: a cohort study using linked electronic health records.Epidemiology and psychiatric sciences · 2021Article
- Recommended First-Line Antiretroviral Therapy Regimens and Risk of Diabetes Mellitus in HIV-Infected Adults in Resource-Limited Settings.Open forum infectious diseases · 2019Article
Corrections and comments
PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.
Authors and funding
9 authors at 1 institution in 2 countries.
Funding
No grant is acknowledged in the PubMed record.
Abstract
Efavirenz is the preferred nonnucleoside reverse transcriptase inhibitor (NNRTI) in first-line antiretroviral therapy (ART) regimens in low- and middle-income countries, where the prevalence of diabetes is increasing. Randomized control trials have shown mild increases in plasma glucose in participants in the efavirenz arms, but no association has been reported with overt diabetes. We explored the association between efavirenz exposure and incident diabetes in a large Southern African cohort commencing NNRTI-based first-line ART. Our cohort included HIV-infected adults starting NNRTI-based ART in a private sector HIV disease management program from January 2002 to December 2011. Incident diabetes was identified by the initiation of diabetes treatment. Patients with prevalent diabetes were excluded. We included 56,298 patients with 113,297 patient-years of follow-up (PYFU) on first-line ART. The crude incidence of diabetes was 13.24 per 1000 PYFU. Treatment with efavirenz rather than nevirapine was associated with increased risk of developing diabetes (hazard ratio 1.27 (95% confidence interval (CI): 1.10-1.46)) in a multivariate analysis adjusting for age, sex, body mass index, baseline CD4 count, viral load, NRTI backbone, and exposure to other diabetogenic medicines. Zidovudine and stavudine exposure were also associated with an increased risk of developing diabetes. We found that treatment with efavirenz, as well as stavudine and zidovudine, increased the risk of incident diabetes. Interventions to detect and prevent diabetes should be implemented in ART programs, and use of antiretrovirals with lower risk of metabolic complications should be encouraged.
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Registered trials
Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.