High-density lipoprotein cholesterol at admission reflects disease course, severity, and influences management decisions in patients with amoebic liver abscess.

Amoebic liver abscess (ALA) remains a major health burden in tropical regions. Our observational study evaluated the association between serum lipid profiles and disease severity in 118 patients with ALA. Patients were classified into uncomplicated and complicated ALA groups. Serum high-density lipoprotein cholesterol (HDL-C) levels were significantly lower in ALA patients compared to controls and further reduced in complicated cases. HDL-C emerged as an independent predictor of complicated ALA and demonstrated better predictive value than conventional inflammatory markers such as total leucocyte count and C-reactive protein. Lower HDL-C levels were also linked to an increased need for percutaneous catheter drainage and longer hospital stay. Post-treatment assessments showed significant improvement in HDL-C levels. These findings suggest that HDL-C is a valuable, low-cost biomarker for assessing ALA severity and guiding clinical decisions, especially in resource-limited settings.