Objective:

To determine the relationship between mitochondrial DNA haplogroups and the incidence of diabetes mellitus (DM) in men with and without HIV, and to explore interactions with mitochondrial-toxic antiretroviral therapy (ART), highlighting the significance of these findings in the context of existing research.

Key Findings:

• African mtDNA haplogroup L3 was associated with a higher risk of incident DM in men with HIV (HR, 1.92; 95% CI, 1.19–3.10).
• Exposure to mitochondrial-toxic ART (D-drugs) was independently associated with an increased risk of DM (HR, 2.8; 95% CI, 1.5–5.3).

Interpretation:

Mitochondrial genetic variability, particularly haplogroup L3, and exposure to certain ART significantly influence the risk of developing DM in men with HIV, suggesting important implications for clinical practice.

Limitations:

• Study focused only on men, limiting generalizability to women.
• Potential confounding factors may not have been fully accounted for, including biases in self-reported data.

Conclusion:

The findings highlight the importance of mitochondrial genetics and ART exposure in assessing diabetes risk among men with HIV, suggesting a need for tailored diabetes prevention strategies in this population, such as monitoring and managing mitochondrial health.