Sub-Saharan Africa is more affected by the HIV epidemic than any other region of the world. At the same time, malnutrition remains a major public health concern. HIV and malnutrition are interlinked, both epidemiologically and physiologically, contributing to high mortality and poor growth and development of children in sub-Saharan Africa. This thesis aims to explore the impact of HIV on the treatment and care of children with severe acute malnutrition in Malawi. The thesis will investigate mortality and nutritional recovery in HIV-infected and uninfected children with SAM; HIV infection and nutritional status in carers of children with SAM; and caregiver perspectives on quality of care for children with SAM. The study is based on a prospective cohort study of 454 children with SAM and meta-analysis of 17 relevant studies; a cross sectional study of 322 carer-child pairs; and a qualitative study using a grounded theory approach.