Diagnostic value of macrophage inflammatory protein-1 beta (MIP-1β) in serum and ascitic fluid of patients with decompensated HCV related cirrhosis with and without spontaneous bacterial peritonitis

Abstract

Background: Spontaneous bacterial peritonitis (SBP) is a life-threatening infection and considered one of the most serious cirrhosis complications because of its frequency, morbidity and mortality rates(10:30%) and its unclear clinical picture; different laboratory diagnostics play a pivotal role for rapid and effective management of SBP patients. Objective of the study: The aim of the study is to assess and evaluate the potential diagnostic efficacy of macrophage inflammatory protein type 1 beta (MIP-1β) in cirrhotic patients and its usefulness in the diagnosis of SBP. Patients and methods: 60 Egyptian patients were evaluated into two groups; Group A: 30 patients with HCV related liver cirrhosis with ascites proved to have SBP (PNL≥250/mm³ in AF) and Group B: 30 patients with HCV related liver cirrhosis with ascites but without SBP (PNL<250/mm³ in AF and negative ascites fluids culture). Different inflammatory markers and MIP-1β in sera and AF in patients of both groups were measured. Results: MIP-1β was significantly increased in AF in patients with SBP versus non SBP (P ≤ 0.001).At the best cut off value 113 pg/ml, diagnostic performance of ascetic MIP-1β in discriminating SBP; the sensitivity of the test was 77.33% while the specificity was 83.33%. While at the best cut off value 123 pg/ml, diagnostic performance of serum MIP-1β in discriminating SBP from non SBP; the sensitivity of the test was 76.67% while the specificity was 80%. Conclusion: MIP-1β is a useful marker in the diagnosis of SBP in cirrhotic patientswith satisfactory sensitivity and specificity. Chemokines should be further explored for diagnostic use. Keywords: Spontaneous bacterial peritonitis, Macrophage inflammatory protein type 1 beta, Ascitic fluids, Chemokines.