Endotoximia and Serum CD163 in Decompensated Liver Cirrhosis: Associations with Disease Severity and Survival Outcomes

Abstract

Background: Liver cirrhosis ranks as the tenth leading cause of mortality in Africa. Decompensation marks disease progression, often involving systemic inflammation and bacterial translocation that contribute to hepatic injury. Objective: This study aimed to evaluate the relationship between s CD163 and LPS-binding protein (LBP) levels with severity of liver disease and 6-month survival in cirrhotic cases with decompensation and acute-on-chronic liver failure (ACLF). Methodology: Fifty liver disease cases were enrolled from the Hepatobiliary unit at Faculty of Medicine, Alexandria University and categorized into acute decompensation (AD) (Group A), acute-on-chronic liver failure (ACLF) (Group B), and chronic liver decompensation (Group C). Forty age- and sex-matched healthy individuals were included. Severity of the liver disease was assessed and serum CRP, sCD163, and LBP levels were detected by ELISA at admission, with follow-up at 1 and 6 months. Results: Patients exhibited significantly higher levels of CRP, sCD163, and LBP than healthy controls. (all p ≤ 0.001). However, none of the markers could distinguish ACLF from other decompensation types. In AD patients, sCD163 correlated strongly with scores of disease severity (Child, MELD, CLIF-SOFA), but not in ACLF. At a cutoff >1235.909 pg/mL, sCD163 predicted mortality with 82.14% sensitivity and 68.18% specificity. Median survival at this level was 3 months (p 0.001). sCD163 emerged as the sole independent predictor of mortality at both 1 and 6 months (p < 0.001). Conclusion: sCD163 serves as an independent prognostic marker for mortality in decompensated liver cirrhosis patients.