An RCT among ART-naïve adults with malnutrition in Tanzania and Zambia demonstrated that a lipid-based nutritional supplement with additional vitamins and minerals significantly increased mean CD4 T lymphocyte count at 12 weeks post-ART compared to a lipid-based nutritional supplement alone, however high-dose supplements did not significantly improve clinical outcomes including mortality and CD4 T lymphocyte count on ART [12]. Here, CD4 is linked to nutritional deficiency disease.