The invention of Highly Active Antiretroviral Therapy (HAART) has achromatized the HumanrnImmunodeficiency Virus (HIV) infection from a fatal disease to a chronic condition marked byrnreduced morbidity and mortality. This success in controlling HIV replication and restoring immunityrnhas been displeasured by the acclamation that metabolic changes, such as Insulin Resistance (IR) arernincreasing among people living with HIV. The goal of this study was to determine IR and assess riskrnfactors associated with it among HIV infected patients receiving efavirenz (EFV) based antiretroviralrnmedications alone and in combination with rifampicin (RIF) based anti-Tuberculosis (TB)rnmedications. A prospective and comparative two arm cohort study of 30 HIV infected patients onrnHAART and 30 TB-HIV coinfected patients on HAART and Anti-Tuberculosis drugs was employed.rnBlood samples of patients with HIV infection and TB-HIV co-infection were identified andrncompared for presence of insulin resistance. Association between insulin resistance and risk factorsrnwas analyzed. The Mean Triglyceride to Glucose (TyG) index, the measure of IR, in HIV infectedrngroups receiving EFV based HAART alone and TB-HIV co-infected groups receiving EFV basedrnHAART in combination with RIF based anti TB, was not significantly different. Baseline plasmarntriglyceride was associated with elevated TyG index and IR (OR, 95% CI = 1.170; p < 0.01) in thernTB-HIV co-infected groups. In both treatment groups, a significant mean difference in IR wasrnobserved in patients with an advanced HIV infection. In HIV only treatment group, a higher meanrnTyG was found among stage 4 patients at week 4 (p = 0.034) and week 16 (p = 0.049); and in TB HIVrncotreatmentrngroups,rnarnhigherrnmeanrnTyGrnindexrnwasrnfoundrnamongrnstagern4 patientsrnatrnweekrn16 (p =rnrn0.019).rnNornsignificantrnrndifference in insulin resistance was observed between HIV patients receivingrnEFV based Antiretroviral Therapy (ART) alone and TB-HIV co-infected patients receiving EFVrnbased ART with RIF based Anti TB medications. EFV based HAART can lead to insulin resistancernindependent of HIV and non-HIV related risk factors.