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

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. A prospective observational study was conducted at Shanghai Public Healt...

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Main Authors: 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
Format: Article
Language:English
Published: Taylor & Francis Group 2025-12-01
Series:Emerging Microbes and Infections
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Online Access:https://www.tandfonline.com/doi/10.1080/22221751.2025.2479634
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author 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
author_facet 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
author_sort Jinfeng Sun
collection DOAJ
description 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. 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. 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. 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..
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spelling doaj-art-00bc5772018b4e279d936a42d2c602a92025-08-20T02:41:43ZengTaylor & Francis GroupEmerging Microbes and Infections2222-17512025-12-0114110.1080/22221751.2025.2479634Monocyte distribution width (MDW) as a reliable diagnostic biomarker for sepsis in patients with HIVJinfeng Sun0Yueming Shao1Rui Jiang2Tangkai Qi3Jingna Xun4Yinzhong Shen5Renfang Zhang6Liu Qian7Xialin Wang8Li Liu9Zhenyan Wang10Jianjun Sun11Yang Tang12Wei Song13Shuibao Xu14Junyang Yang15Youming Chen16Yi-Wei Tang17Hongzhou Lu18Jun Chen19Department of Infection and Immunology, Shanghai Public Health Clinical Center, Fudan University, Shanghai, People’s Republic of ChinaDepartment of Infection and Immunology, Shanghai Public Health Clinical Center, Fudan University, Shanghai, People’s Republic of ChinaDepartment of Infection and Immunology, Shanghai Public Health Clinical Center, Fudan University, Shanghai, People’s Republic of ChinaDepartment of Infection and Immunology, Shanghai Public Health Clinical Center, Fudan University, Shanghai, People’s Republic of ChinaDepartment of Infection and Immunology, Shanghai Public Health Clinical Center, Fudan University, Shanghai, People’s Republic of ChinaDepartment of Infection and Immunology, Shanghai Public Health Clinical Center, Fudan University, Shanghai, People’s Republic of ChinaDepartment of Infection and Immunology, Shanghai Public Health Clinical Center, Fudan University, Shanghai, People’s Republic of ChinaMedical Affairs Department, Beckman-Coulter, Danaher Corporation (China), Shanghai, People's Republic of ChinaMarketing Department, Beckman-Coulter, Danaher Corporation (China), Shanghai, People's Republic of ChinaDepartment of Infection and Immunology, Shanghai Public Health Clinical Center, Fudan University, Shanghai, People’s Republic of ChinaDepartment of Infection and Immunology, Shanghai Public Health Clinical Center, Fudan University, Shanghai, People’s Republic of ChinaDepartment of Infection and Immunology, Shanghai Public Health Clinical Center, Fudan University, Shanghai, People’s Republic of ChinaDepartment of Infection and Immunology, Shanghai Public Health Clinical Center, Fudan University, Shanghai, People’s Republic of ChinaDepartment of Infection and Immunology, Shanghai Public Health Clinical Center, Fudan University, Shanghai, People’s Republic of ChinaDepartment of Infection and Immunology, Shanghai Public Health Clinical Center, Fudan University, Shanghai, People’s Republic of ChinaDepartment of Infection and Immunology, Shanghai Public Health Clinical Center, Fudan University, Shanghai, People’s Republic of ChinaDepartment of Infection and Immunology, Shanghai Public Health Clinical Center, Fudan University, Shanghai, People’s Republic of ChinaMedical Affairs Department, Danaher Corporation/Cepheid, New York, USADepartment of Infectious Diseases, National Clinical Research Center for Infectious Diseases, Shenzhen Third People’s Hospital, Shenzhen, People’s Republic of ChinaDepartment of Infection and Immunology, Shanghai Public Health Clinical Center, Fudan University, Shanghai, People’s Republic of ChinaSepsis 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. 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. 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. 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..https://www.tandfonline.com/doi/10.1080/22221751.2025.2479634Biomarkershuman immunodeficiency virus (HIV)monocyte distribution width (MDW)sepsisSepsis-3
spellingShingle 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
Monocyte distribution width (MDW) as a reliable diagnostic biomarker for sepsis in patients with HIV
Emerging Microbes and Infections
Biomarkers
human immunodeficiency virus (HIV)
monocyte distribution width (MDW)
sepsis
Sepsis-3
title Monocyte distribution width (MDW) as a reliable diagnostic biomarker for sepsis in patients with HIV
title_full Monocyte distribution width (MDW) as a reliable diagnostic biomarker for sepsis in patients with HIV
title_fullStr Monocyte distribution width (MDW) as a reliable diagnostic biomarker for sepsis in patients with HIV
title_full_unstemmed Monocyte distribution width (MDW) as a reliable diagnostic biomarker for sepsis in patients with HIV
title_short Monocyte distribution width (MDW) as a reliable diagnostic biomarker for sepsis in patients with HIV
title_sort monocyte distribution width mdw as a reliable diagnostic biomarker for sepsis in patients with hiv
topic Biomarkers
human immunodeficiency virus (HIV)
monocyte distribution width (MDW)
sepsis
Sepsis-3
url https://www.tandfonline.com/doi/10.1080/22221751.2025.2479634
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