Monocyte distribution width (MDW) as a reliable diagnostic biomarker for sepsis in patients with HIV

Jinfeng Sun; Yueming Shao; Rui Jiang; Tangkai Qi; Jingna Xun; Yinzhong Shen; Renfang Zhang; Liu Qian; Xialin Wang; Li Liu; Zhenyan Wang; Jianjun Sun; Yang Tang; Wei Song; Shuibao Xu; Junyang Yang; Youming Chen; Yi-Wei Tang; Hongzhou Lu; Jun Chen

doi:10.1080/22221751.2025.2479634

Emerging Microbes and Infections (Mar 2025)

Monocyte distribution width (MDW) as a reliable diagnostic biomarker for sepsis in patients with HIV

Jinfeng Sun,
Yueming Shao,
Rui Jiang,
Tangkai Qi,
Jingna Xun,
Yinzhong Shen,
Renfang Zhang,
Liu Qian,
Xialin Wang,
Li Liu,
Zhenyan Wang,
Jianjun Sun,
Yang Tang,
Wei Song,
Shuibao Xu,
Junyang Yang,
Youming Chen,
Yi-Wei Tang,
Hongzhou Lu,
Jun Chen

Affiliations

Jinfeng Sun: Department of Infection and Immunology, Shanghai Public Health Clinical Center, Fudan University, Shanghai, China
Yueming Shao: Department of Infection and Immunology, Shanghai Public Health Clinical Center, Fudan University, Shanghai, China
Rui Jiang: Department of Infection and Immunology, Shanghai Public Health Clinical Center, Fudan University, Shanghai, China
Tangkai Qi: Department of Infection and Immunology, Shanghai Public Health Clinical Center, Fudan University, Shanghai, China
Jingna Xun: Department of Infection and Immunology, Shanghai Public Health Clinical Center, Fudan University, Shanghai, China
Yinzhong Shen: Department of Infection and Immunology, Shanghai Public Health Clinical Center, Fudan University, Shanghai, China
Renfang Zhang: Department of Infection and Immunology, Shanghai Public Health Clinical Center, Fudan University, Shanghai, China
Liu Qian: Beckman-Coulter, Danaher Corporation (China), Shanghai, China
Xialin Wang: Beckman-Coulter, Danaher Corporation (China), Shanghai, China
Li Liu: Department of Infection and Immunology, Shanghai Public Health Clinical Center, Fudan University, Shanghai, China
Zhenyan Wang: Department of Infection and Immunology, Shanghai Public Health Clinical Center, Fudan University, Shanghai, China
Jianjun Sun: Department of Infection and Immunology, Shanghai Public Health Clinical Center, Fudan University, Shanghai, China
Yang Tang: Department of Infection and Immunology, Shanghai Public Health Clinical Center, Fudan University, Shanghai, China
Wei Song: Department of Infection and Immunology, Shanghai Public Health Clinical Center, Fudan University, Shanghai, China
Shuibao Xu: Department of Infection and Immunology, Shanghai Public Health Clinical Center, Fudan University, Shanghai, China
Junyang Yang: Department of Infection and Immunology, Shanghai Public Health Clinical Center, Fudan University, Shanghai, China
Youming Chen: Department of Infection and Immunology, Shanghai Public Health Clinical Center, Fudan University, Shanghai, China
Yi-Wei Tang: Danaher Corporation/Cepheid, New York, USA
Hongzhou Lu: Department of Infectious Diseases, National Clinical Research Center for Infectious Diseases, Shenzhen Third People’s Hospital, Shenzhen, China
Jun Chen: Department of Infection and Immunology, Shanghai Public Health Clinical Center, Fudan University, Shanghai, China

DOI: https://doi.org/10.1080/22221751.2025.2479634

Abstract

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Introduction: Sepsis is a leading cause of death among patients with HIV, but early diagnosis remains a challenge. This study evaluates the diagnostic performance of monocyte distribution width (MDW) in detecting sepsis in patients with HIV.Methods: A prospective observational study was conducted at Shanghai Public Health Center, involving 488 hospitalized patients with HIV aged 18-65 between December 2022 and August 2023. MDW was measured at admission, and its diagnostic accuracy was compared with Sepsis-3 criteria. Survival rates on day 28 and 90 were also recorded. Additionally, five machine learning (ML) models were tested to enhance diagnostic efficacy.Results: Of 488 subjects, 90 were in the sepsis group and 398 in the control group. MDW showed a diagnostic area under the curve (AUC) of 0.82, comparable to C-reactive protein (CRP) and Procalcitonin (PCT) with AUCs of 0.78 and 0.82, respectively. With a cut-off value of 25.25, MDW had a sensitivity of 0.83 and specificity of 0.76. The positive and negative predictive values were 44% and 95%, respectively. When MDW was combined with platelet count, serum albumin, and hemoglobin in a random forest model, the AUC improved to 0.931. The model achieved a sensitivity of 1.00 and specificity of 0.732.Conclusion: MDW is a useful diagnostic marker for sepsis in patients with HIV, with strong sensitivity and specificity. Combining MDW with other lab markers can further enhance diagnostic accuracy.Trial registration: ClinicalTrials.gov identifier: NCT05036928..

Published in Emerging Microbes and Infections

ISSN: 2222-1751 (Online)
Publisher: Taylor & Francis Group
Country of publisher: United Kingdom
LCC subjects: Medicine: Internal medicine: Infectious and parasitic diseases; Science: Microbiology
Website: https://www.tandfonline.com/journals/temi

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