Study of Neutrophil CD64 and HLA-DR as Early Detection Markers of Sepsis in Hepatic ICU Patients

Abstract Background Sepsis is the commonest cause of death in liver cirrhosis patients. Aim Evaluation of neutrophil and monocyte CD64 and HLA-DR as early biomarkers predicting sepsis in liver cirrhosis. Methods This case-control study involved 70 cirrhotic patients (35 with sepsis and 35 without) and 30 healthy individuals. Laboratory studies were performed, including CD64 and HLA-DR using flow cytometry along with sepsis index (SI). Results Patients were mainly males (80%), aged 62.17 and 64.69 years respectively. Mono CD64% at Cut-off: >62.9 showed AUC: 0.676, Sensitivity: 80.0%, Specificity: 60.0%, PPV: 66.7%, and NPV: 75.0%. while Mono CD64 MFI at Cut-off > 9.5 shoed AUC: 0.659, Sensitivity: 94.29%, Specificity: 37.14%, PPV: 60.0%, and NPV: 86.7%. Combinations of CRP + Lactate + Mono CD64%+ Mono CD64 MFI revealed AUC: 0.929, Sensitivity: 82.86%, Specificity: 91.43%, PPV: 90.6%, and NPV: 84.2% Mono CD64% and CD64 MFI (0.003; 0.03) respectively. Regression analysis defined Mono CD64% >62.9 (OR 6), Mono CD64 MFI > 9.5 (OR 9.75), CRP > 32.4 (OR 13.5), lactate > 1.93 (OR 12.08), and ALBI score > 0.01 (OR 6) all as factors affecting early sepsis in cirrhosis. Conclusion Mono CD64% and Mono CD64 MFI proved efficacy as early septic biomarkers with higher efficacy when combined with traditional inflammatory markers in liver cirrhosis patients.