Another condition in which alterations in patients' immune response may significantly influence outcome is liver cirrhosis. Berry et al. [14] showed that a reduction in HLA-DR expression by monocytes to less than 40% of admission values was highly correlated with increased 90-day mortality. The changes in HLA-DR expression were also associated with reduced Th1 response to antigenic stimulation and exaggerated secretion of the antiinflammatory cytokines IL-10 and IFN-c.