Fig. 1: The HIV-SM case-control participants selection consort and post-discharge growth trajectories.

A Study participants selection consort of the HIV-SM case-control study. For the effect of HIV on post-discharge growth analysis, the study included 834 children from the CHAIN cohort of whom 112 had HIV infection. To unravel systemic proteome processes associated with HIV status, the study analysed 689 children (those with plasma proteomics data measured at hospital discharge) of whom 79 had HIV infection. Children who lacked proteomics data were excluded from this analysis. For the growth mechanistic analysis to understand impact of HIV-associated biological processes on growth, children who died post-discharge, lacked proteome data or were not severely wasted were excluded, retaining 217 children of whom 38 had HIV. B Depicts box plots of 180 days post-discharge mid-upper arm circumference (MUAC), weight-for-age z score (WAZ), weight-for-height z score (WHZ) and height-for-age z score (HAZ) trajectories, stratified by HIV status. Data are presented as median values with interquartile ranges (IQR). The plots include fitted LOESS (locally estimated scatterplot smoothing) function (red and blue lines) to show the post-discharge growth rates. The red and blue colours represent the HIV positive (n = 112) and HIV negative (n = 722) groups, respectively. Green horizontal dashed lines show the threshold for severe malnutrition based either on MUAC (11.5 cm) or Z score of (-3) for WAZ, WHZ, and HAZ. Box plots indicate; median (middle line); 25th (first quartile, Q1) and 75th (third quartile, Q3) percentile (box limits); error bars (whiskers) represent 1.5*Q1 and Q3 while single points outside the error bars represent outliers. C Shows mean post-discharge anthropometric gains overall and results from an interaction analysis between HIV status and time. Beta coefficient estimates and p-values were obtained using a fixed-effects panel model (Eq. 1), where children without HIV served as the reference group. Statistically significant results were identified based on p < 0.05. For each predictor, significance was assessed with t-statistics, while the F-test evaluated overall model significance, as implemented in the plm function from the plm R package. The exact p values for the relationships between MUAC, WAZ, WHZ, and HAZ with TimePoint are as follows: MUAC and TimePoint, p = 5.31e-186; WAZ and TimePoint, p = 6.24e-69; WHZ and TimePoint, p = 7.00e-73; and HAZ and TimePoint, p = 1.74e-10. For the interaction effects in the model, the exact p-values are as follows: TimePoint*HIV status and MUAC, p = 3.35e-06; TimePoint*HIV status and WAZ, p = 2.17e-05. Abbreviations: Discharge, hospital discharge time point; Day 45, 45 days post-discharge; Day 90, 90 days post-discharge; Day 180, 180 days post-discharge; CI, confidence interval.