Plasma proteomics reveals markers of metabolic stress in HIV infected children with severe acute malnutrition: call for more evidence-based nutritional intervention strategies

HIV infection affects up to 30% of children presenting with severe acute malnutrition (SAM) in Africa and is associated with increased mortality. Children with SAM are treated similarly regardless of the presence of HIV although mechanisms of nutritional recovery in HIV and/or SAM are not well understood. We aimed to test the hypothesis that metabolic and inflammatory perturbations among children with SAM differed between those with HIV (n = 54) and without HIV (n = 113) to better understand their specific nutritional and therapeutic requirements. We performed a secondary analysis of a clinical trial and plasma proteomics data among children with complicated SAM in Kenya and Malawi. Compared to children with SAM without HIV, HIV-infected children had evidence (false discovery rate corrected p