Aim: To determine if home- based nutritional therapy will benefit a signific ant fraction of malnourished, HIV- infected Malawian children, and to determine if ready- to- use therapeutic food (RUTF) is more effective in home- based n utritional therapy than traditional foods. Methods: 93 HIV- positive children > 1 y old discharged from the nutrition unit in Blantyre, Malawi were systematica lly allocated to one of three dietary regimens: RUTF, RUTF supplement or blended maize/soy flour. RUTF and maize/soy flour provided 730 kJ· kg- 1· d- 1,whil e the RUTF supplement provided a fixed amount of energy, 2100 kJ/d. These childr en did not receive antiretroviral chemotherapy. Children were followed fortnight ly. Children completed the study when they reached 100% weight- for- height, relapsed or died. Outcomes were compared using regression modeling to account f or differences in the severity of malnutrition between the dietary groups. Resul ts: 52/93 (56% ) of all children reached 100% weight- for- height. Regressi on modeling found that the children receiving RUTF gained weight more rapidly an d were more likely to reach 100% weight- for- height than the other two diet ary groups (p < 0.05). Conclusion: More than half of malnourished, HIV- infecte d children not receiving antiretroviral chemotherapy benefit from home- based n utritional rehabilitation. Home- based therapy RUTF is associated with more rap id weight gain and a higher likelihood of reaching 100% weight- for- height. Aim: To determine if home-based nutritional therapy will benefit a significant fraction of malnourished, HIV-infected Malawian children, and to determine if ready-to- use therapeutic food (RUTF) is more effective in home-based nutritional therapy than Traditional foods. Methods: 93 HIV-positive children> 1 y old discharged from the nutrition unit in Blantyre, Malawi were systematically l l allocated to one of three dietary regimens: RUTF, RUTF supplement or blended maize / soy flour. RUTF and maize / soy flour provided 730 kJ · kg-1 · d-1, whil e the RUTF supplement provided a fixed amount of energy, 2100 kJ / d. These childr en did not receive antiretroviral chemotherapy. Children were followed fortnight ly. who reached 100% weight- for- height, relapsed or died. Outcomes were comparing using regression modeling to account f or differences in the severity of malnutrition between the dietary groups. Resul ts: 52/93 (56%) of all children reached 100 % w Regressi on modeling found that the children receiving RUTF gained weight more rapid an d were more likely to reach 100% weight-for-height than the other two dietary ary groups (p <0.05). Conclusion: More than half of malnourished, HIV-infecte d children not receiving antiretroviral chemotherapy benefit from home-based n utritional rehabilitation. Home-based therapy RUTF is associated with more rap id weight gain and a higher likelihood of reaching 100% weight-for-height.