CD4 count below threshold, children aged < 1 year and 1–5 years, baseline malnutrition in the form of severe wasting (WFH <  − 3z), not taking cotrimoxazole preventive therapy, and baseline Hgb < 10 gm/dl were significant predictors of mortality among HIV-positive children after initiation of ART. Here, CD4 is linked to nutritional deficiency disease.