Dear editor This letter is a response to the recent paper by Anigilaje and Olutola entitled “Prevalence and risk factors of undernutrition among antiretroviral-therapy-naive subjects aged under 5 years old in Makurdi, Nigeria: a retrospective study”, published in the International Journal of General Medicine.1 The relevance and importance of any sound research on undernutrition in HIV-infected children is high, and we strongly support publication of papers on this topic. However, while we appreciate the health awareness that could be generated by this paper, we have some concerns regarding this study. The title of the article and the labeling of its tables indicate that the study population included children aged younger than 5 years, but it is also stated that the selection criteria included HIV-infected children ≤15 years. Further, it mentioned in Table 1 that the total sample was 182, and only children with undernutrition were included. In the methods section, it is stated that upon enrollment into care, all parents or caregivers of HIV-infected children were required to provide written informed consent for use of their data for research purposes. Informed consent is voluntary for any research, and should not affect the care provided. It is not clear in the present study if the informed consent was voluntary. The results report the prevalence of undernutrition to be 12.1% (22/182), 33.5% (61/182), and 54.4% (99/182) for underweight, wasting, and stunting, respectively. What is actually being reported here is the proportions of underweight, wasting, and stunting among undernourished children, but to estimate the prevalence of undernutrition, the study sample should have included all HIV-infected children younger than 5 years irrespective of their nutritional status. In order to identify risk factors for undernutrition, comparisons should have been made between each of the three undernourished groups and children without undernutrition, and not between the undernourished groups themselves. The table captions appear to be mislabeled. Table 2 denotes the prevalence and risk factors for wasting and not for underweight (sample size is 61, not 22) and Table 3 shows the prevalence and risk factors for underweight and not for wasting (sample size is 22, not 61). This mislabeling has resulted in erroneous interpretation of the results and hence the discussion of the findings. In the tables, the crude odds ratios for some variables show a significant P-value, but the adjusted odds ratio and confidence interval for two variables are not included (see mode of HIV transmission and caregivers’ HIV status in Table 2 and caregivers’ HIV status in Tables 3 and 4). It is also observed that the odds ratio and confidence interval for some variables are missing, but the crude odds ratios have been mentioned with a P-value as 0.000 (modes of infant feeding in Tables 2–4). Some variables are significant risk factors based on the crude odds ratio, but are significant protective factors after multivariate analysis (caregiver on highly active antiretroviral therapy, marital status of caregiver, tuberculosis, and esophageal candidiasis in Table 2, and age and CD4 count in Table 3). The justification for this major difference is not stated in the article. The authors have included all variables achieving a significance of 0.1 in the multivariate analysis. It is advisable to include only those significant variables that could be confounding to the variable of interest. When interpreting the results, the authors state that “the trend was such that female subjects were 0.292 less likely to be underweight”. This result could be better reported as females being 71% less likely to be underweight than males. The authors attribute the lack of a significant association in multivariate analysis between “wasting” (corrected here to “underweight”) and the tested variables to the small sample size. It would be appropriate to mention if the sample size was estimated before the start of the study and whether the available size was adequate. The authors state that the lack of data on HIV-negative children in a similar setting limited their interpretation of the results. This is not a study limitation, because the authors did not intend to include HIV-negative children; however, this could be a recommendation for future research. Considering the public health importance of this issue, studies with more methodological rigor are recommended in order to draw concrete conclusions for clinical practice.