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Abacavir and lamivudine concentrations were measured as a secondary objective on day 1 and day 14 and patients were followed\u2010up to week 48. Population PK of abacavir and lamivudine were described using NONMEM.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>In total, 623 abacavir and 627 lamivudine concentrations were collected from 75 paediatric patients aged 0.1\u201310.8 (median 1.4) years. Abacavir PK was described by a 2\u2010compartment model, patients randomized to early ART showed increased bioavailability of 31%. Apparent clearance (CL\/F, L\/h\/7\u00a0kg) of abacavir increased from day 1 to day 14 from 3.33 (95% confidence interval 2.71\u20134.12) to 5.86 (95% confidence interval 4.78\u20137.3). A 1\u2010compartment model described lamivudine PK, variability on CL\/F was explained by maturation with age, with age at half\u2010matured CL\/F being 4\u00a0months. For both drugs allometrically scaled total body weight was related to CL\/F and apparent volume of distribution. PK exposure did not correlate with virological outcomes or death at 12 or 48\u00a0weeks.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusion<\/jats:title><jats:p>Increases in Abacavir's CL\/F between day 1 to day 14, bioavailability and PK variability with early start of ART was found in this cohort of severely malnourished children; however, these changes did not influence virological outcomes. 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