Supplementary file 1_Caregiver burden and malnutrition in patients with HIV-associated lymphoma: indirect pathways via symptom distress and family closeness, and a test of resilience as a mediator.docx

Symptom burden, caregiver burden, psychological resilience, and family closeness were assessed using standardized instruments. Univariable and multivariable linear regression analyses were conducted using HC3 heteroscedasticity-consistent inference. Indirect statistical associations were examined using bootstrap analyses, followed by exploratory subgroup and sensitivity analyses.</p>Results<p>Higher symptom burden and IPI risk were associated with higher PG-SGA total scores, whereas higher CD4 + T-cell counts and serum albumin concentrations were associated with lower scores (all p ≤ 0.005).

Age, sex, and caregiver burden were not independently associated with PG-SGA score. Exploratory analyses provided no statistically supported evidence of an indirect association through symptom burden or of differences by age, sex, or CD4 + T-cell count. Sensitivity analyses produced consistent conclusions.</p>Conclusion<p>Nutritional status in patients with HIV-associated lymphoma was associated mainly with symptom burden, immune status, serum albumin, and lymphoma prognostic risk.

Caregiver burden showed neither an independent association with PG-SGA score nor a confirmed indirect association through symptom burden. Larger multicenter longitudinal studies are needed to clarify the temporal relationships among caregiver burden, psychosocial factors, and nutritional status.</p>