{
  "abstract": "Infections are major drivers of decompensation and mortality in cirrhosis. High-density lipoprotein (HDL) and its major protein component apolipoprotein A-I (apoA-I) exhibit immune-modulatory properties, yet their role in predicting infection risk in cirrhosis remains poorly defined. This single-centre cohort study evaluated baseline HDL cholesterol (HDL-C) and apoA-I in 311 patients with cirrhosis (training: n = 225; temporal validation: n = 86). The primary endpoint was infection requiring antibiotic therapy within 12 months. Cox regression, C-indices and censoring-adjusted time-dependent ROC analyses assessed prognostic performance. Infections occurred in 24% of the training and 31% of the validation cohort. Lower HDL-C and apoA-I levels were significantly associated with infection risk in both cohorts. In the training cohort, both biomarkers improved discrimination when added to MELD. The biomarker models achieved higher C-indices and numerically higher 12-month AUCs than MELD and Child-Pugh alone. Discrimination attenuated in the validation cohort, where the biomarker-based models performed comparably to the established MELD and Child-Pugh scores. Training-derived exploratory cut-offs of HDL-C < 40.4 mg/dL and apoA-I < 98.5 mg/dL identified groups with higher infection risk. Occurrence of infection signaled a clear transition towards an unfavorable clinical trajectory, with a mortality rate of 41% during follow-up. These findings support HDL-C and apoA-I as candidate prognostic biomarkers of infection susceptibility. External validation and prospective assessment of clinical utility are needed; causal and therapeutic implications require dedicated investigation.",
  "abstract_shown": true,
  "affiliations": [],
  "article_type": null,
  "arxiv": null,
  "author_total": 9,
  "authors": [
    {
      "name": "Florian Rainer"
    },
    {
      "name": "Markus Trieb"
    },
    {
      "name": "Angela Horvath"
    },
    {
      "name": "Philipp Douschan"
    },
    {
      "name": "Hubert Scharnagl"
    },
    {
      "name": "Ákos Heinemann"
    },
    {
      "name": "Gunther Marsche"
    },
    {
      "name": "Vanessa Stadlbauer"
    },
    {
      "name": "Rudolf E. Stauber"
    }
  ],
  "bibtex": "https://research.draconitic.com/paper/28d8t75ss8a8b.bib",
  "cited_by": 0,
  "doi": "10.1038/s41598-026-74841-5",
  "fulltext_url": null,
  "id": "28d8t75ss8a8b",
  "issns": [
    "2045-2322"
  ],
  "landing_url": "https://www.nature.com/articles/s41598-026-74841-5",
  "language": null,
  "licence": "CC-BY-4.0",
  "licence_label": "CC BY 4.0",
  "licence_source": "article",
  "licence_url": "https://creativecommons.org/licenses/by/4.0",
  "metadata_licence": null,
  "native_subjects": [
    [
      "openalex",
      "2721|Liver Disease and Transplantation"
    ]
  ],
  "openalex": "W7221355361",
  "pdf_url": "https://www.nature.com/articles/s41598-026-74841-5_reference.pdf",
  "pmcid": null,
  "pmid": null,
  "published": "2026-10-11",
  "publisher": "Springer Science and Business Media LLC",
  "ris": "https://research.draconitic.com/paper/28d8t75ss8a8b.ris",
  "sources": [
    {
      "first_seen": "2026-10-30T12:17:26Z",
      "native_id": "10.1038/s41598-026-74841-5",
      "source": "crossref",
      "url": "https://www.nature.com/articles/s41598-026-74841-5"
    }
  ],
  "subjects": [
    {
      "field": "medicine",
      "origin": "openalex:2721|Liver Disease and Transplantation",
      "subfield": "general"
    }
  ],
  "title": "Lipoprotein-related biomarkers HDL-C and apoA-I predict infection risk in patients with liver cirrhosis",
  "title_text": "Lipoprotein-related biomarkers HDL-C and apoA-I predict infection risk in patients with liver cirrhosis",
  "type": "peer-reviewed",
  "updated_at": "2026-10-30T12:17:26Z",
  "url": "https://research.draconitic.com/paper/28d8t75ss8a8b",
  "venue": "Scientific Reports",
  "versions": []
}