Supplementary table 1: Follow up time and censoring reasons when censoring participants at the time of first drug switch.
Variable Category Whole cohort Efavirenz-containing ART Nevirapine-containing ART
Number of patients 56,298
46,666 9,632
Follow up time (years) Median (IQR) 1.32 (0.56 - 2.43) 1.30 (0.56 - 2.36) 1.48 (0.62 - 2.78)
Patient years 97,667 78,693 18,974
3 or more years of follow-up 17.05% 21.86% 16.05%
Reason for censoring Diabetes 1272 (2.26%) 1078 (2.31%) 194 (2.01%)
Drug switch within 1
stline 8712 (15.47%) 6410 (13.74%) 2302 (23.9%)
Switch to PI 2891 (5.14%) 2209 (4.73%) 682 (7.08%)
Study end 34457 (61.2%) 29494 (63.2%) 4963 (51.53%)
Death 1551 (2.75%) 1323 (2.84%) 228 (2.37%)
Left scheme 7415 (13.17%) 6152 (13.18%) 1263 (13.11%)
Crude diabetes incidence
Events/1000 patient years 13.02 13.70 10.22
PI: Protease Inhibitor
IQR: Interquartile Range
Supplementary Table 2: Multivariate Cox regression model of associations with incident diabetes including calendar year. Drug switches within first line regimen included in the model, with censoring at switch to second line therapy. All results are based on multiple imputation.
Variable Category Multivariate
HR (95% CI) Non-Nucleoside Reverse
Transcriptase Inhibitor
Efavirenz 1.28 (1.10 - 1.48)
Nevirapine Referent
Nucleoside Reverse Transcriptase Inhibitor
Zidovudine 1.32 (1.16 - 1.50) Stavudine 1.56 (1.32 - 1.84)
Other Referent
Exposure to other
Diabetogenic Drugs
1.51 (1.36 - 1.69)
Baseline Age (years)
19-24 0.46 (0.27 - 0.80)
25-34 0.71 (0.62 - 0.81)
35-44 Referent
45-54 1.38 (1.21 - 1.56)
>=55 1.67 (1.34 - 2.08)
Sex male 1.48 (1.32 - 1.66)
female Referent
Baseline Body Mass Index (kg/m2)
10 - 17 0.31 (0.20 - 0.49) 18 - 24 0.60 (0.51 - 0.70)
25 - 34 Referent
35+ 1.61 (1.30 - 1.98)
Baseline CD4 Count (cells/μl)
0-199 1.08 (0.93 - 1.24)
200-349 Referent
350+ 1.12 (0.93 - 1.36)
Baseline Viral Load (copies/ml)
0-999 1.23 (1.03 - 1.46)
1000-99 999 Referent
100 000-999 999
>=1 000 000
1.03 (0.91 - 1.17) 1.18 (0.91 - 1.54)
HR: Hazard Ratio CI: Confidence Interval
Calendar year
2002 2003 2004 2005 2006 2007 2008 2009 2010 2011
Referent 0.97 (0.71 - 1.33) 1.06 (0.77 - 1.46) 0.83 (0.59 - 1.16) 0.89 (0.64 - 1.24) 0.87 (0.66 - 1.14) 1.03 (0.78 - 1.36) 1.00 (0.75 - 1.33) 0.82 (0.61 - 1.10) 0.65 (0.44 - 0.96)
Supplementary Table 3: Cox proportionate multivariate model censored at first ever drug switch, including competing risk. Results are based on multiple imputation
HR: Hazard Ratio CI: Confidence Interval
Variable Category Multivariate
HR (95% CI) Non-Nucleoside Reverse
Transcriptase Inhibitor
Efavirenz 1.26 (1.07 - 1.49) Nevirapine Referent
Nucleoside Reverse Transcriptase Inhibitor
Zidovudine 1.39 (1.21 - 1.60) Stavudine 1.67 (1.41 - 1.97)
Other Referent
Exposure to other
Diabetogenic Drugs
1.54 (1.37 - 1.73)
Baseline Age (years)
19-24 0.52 (0.29 - 0.93) 25-34 0.71 (0.61 - 0.82)
35-44 Referent
45-54 1.36 (1.19 - 1.56)
>=55 1.66 (1.31 - 2.10)
Sex male 1.47 (1.31 - 1.66)
female Referent
Baseline Body Mass Index (kg/m2)
10 - 17 0.34 (0.19 - 0.61) 18 - 24 0.60 (0.48 - 0.76)
25 - 34 Referent
35+ 1.57 (1.24 - 1.98)
Baseline CD4 Count (cells/μl)
0-199 1.11 (0.96 - 1.27)
200-349 Referent
350+ 1.11 (0.91 - 1.35)
Baseline Viral Load (copies/ml)
0-999 1.28 (1.07 - 1.53) 1000-99 999 Referent
100 000-999 999 0.98 (0.86 - 1.13)
>=1 000 000 1.14 (0.87 - 1.50)
Supplementary Table 4: Univariate, Multivariate, and Model selection results for the Cox regression model of association with incident diabetes, excluding virally suppressed patients (VL <400 copies/ml). Drug switches within first line regimen included in the model, with censoring at switch to second line therapy. All results are based on multiple imputation.
Variable Univariate
HR (95% CI)
Multivariate HR (95% CI)
Model Selection (AIC) HR (95% CI)
Non-Nucleoside Reverse Transcriptase Inhibitor
Efavirenz 1.30 (1.12 - 1.52) 1.15 (0.98 - 1.35) 1.16 (0.99 - 1.36)
Nevirapine Referent Referent Referent
Nucleoside Reverse Transcriptase Inhibitor
Zidovudine 1.34 (1.17 - 1.53) 1.40 (1.22 - 1.61) 1.42 (1.23 - 1.63) Stavudine 1.52 (1.28 - 1.80) 1.59 (1.33 - 1.89) 1.62 (1.36 - 1.93)
Other Referent Referent Referent
Exposure to other
Diabetogenic Drugs
1.81 (1.60 - 2.04) 1.61 (1.42 - 1.82)
1.62 (1.43 - 1.83)
Baseline Age (years)
19-24 0.33 (0.18 - 0.60) 0.42 (0.23 - 0.77) 0.42 (0.23 - 0.77) 25-34 0.65 (0.56 - 0.75) 0.71 (0.62 - 0.83) 0.71 (0.61 - 0.83)
35-44 Referent Referent Referent
45-54 1.47 (1.27 - 1.69) 1.32 (1.15 - 1.53) 1.31 (1.13 - 1.51)
>=55 1.61 (1.24 - 2.08) 1.42 (1.09 - 1.84) 1.34 (1.04 - 1.74)
Sex male 1.42 (1.27 - 1.59) 1.48 (1.30 - 1.69) 1.46 (1.28 - 1.66)
female Referent Referent Referent
Baseline Body Mass Index (BMI) Quartile (kg/m/m)
10 - 17 0.40 (0.24 - 0.67) 0.33 (0.19 - 0.56) 0.33 (0.19 - 0.55) 18 - 24 0.69 (0.57 - 0.85) 0.62 (0.50 - 0.78) 0.61 (0.50 - 0.75)
25 - 34 Referent Referent Referent
35+ 1.48 (1.17 - 1.88) 1.64 (1.30 - 2.06) 1.63 (1.30 - 2.04)
Baseline CD4 Count (cells/μl)
0-199 1.05 (0.92 - 1.20) 1.06 (0.92 - 1.22)
200-349 Referent Referent Excluded by AIC
350+ 0.86 (0.62 - 1.18) 0.90 (0.65 - 1.24)
Baseline Viral Load (copies/ml)
0-999 0.73 (0.41 - 1.33) 0.74 (0.40 - 1.34) 0.76 (0.36 - 1.64)
1000-99 999 Referent Referent Referent
100 000-999 999 1.10 (0.97 - 1.24) 1.07 (0.94 - 1.22) 1.05 (0.90 - 1.24)
>=1 000 000 1.16 (0.89 - 1.50) 1.21 (0.93 - 1.58) 1.14 (0.78 - 1.67)
