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Antibodies to soluble liver antigen in patients with various liver diseases: a multicentre study.

AbstractBACKGROUND:
Antibodies to soluble liver antigen (anti-SLA) are specific serological markers of autoimmune hepatitis (AIH). The clinical significance and frequency of anti-SLA have never been reported among AIH patients from Italy and Turkey. To retrospectively assess the estimated prevalence, sensitivity, specificity and clinical significance of anti-SLA in AIH and various liver diseases.
METHODS:
A total of 986 patients who had been tested for serum anti-SLA were included in study. The presence of anti-SLA was detected using recombinant enzyme linked immunosorbent assay and immuno-blot. The general characteristics and outcome of patients were obtained from their medical records.
RESULTS:
Antibodies to SLA were found in 30 (3%) of 986 patients. Of these, 27 (90%) had AIH and its variants, whereas the remaining three (10%) had primary biliary cirrhosis. The prevalence of anti-SLA was 9% in AIH patients from Italy and 15% in patients from Turkey. The specificity of these antibodies was 99.5%, whereas sensitivity was 11%. The positive predictive and negative predictive values were 90% and 77.5% respectively (95% confidence interval). Biochemical remission was achieved in 90% of anti-SLA positive AIH patients, but relapse after immunosuppressive withdrawal or during maintenance therapy was observed in 53% of the patients.
CONCLUSIONS:
Seropositivity for anti-SLA occurs at similar frequencies in AIH patients from different geographical regions and ethnic groups. The sensitivity of anti-SLA is low, but it has high specificity for AIH. Additional studies are necessary to prove clinical significance of anti-SLA in AIH.
AuthorsCumali Efe, Ersan Ozaslan, Staffan Wahlin, Tugrul Purnak, Luigi Muratori, Chiara Quarneti, Osman Yüksel, Paolo Muratori
JournalLiver international : official journal of the International Association for the Study of the Liver (Liver Int) Vol. 33 Issue 2 Pg. 190-6 (Feb 2013) ISSN: 1478-3231 [Electronic] United States
PMID23295051 (Publication Type: Comparative Study, Journal Article, Multicenter Study)
Copyright© 2012 John Wiley & Sons A/S.
Chemical References
  • Autoantigens
  • Hepatitis Antibodies
  • liver antigen LA-1
Topics
  • Autoantigens (immunology)
  • Enzyme-Linked Immunosorbent Assay
  • Hepatitis Antibodies (blood)
  • Hepatitis, Autoimmune (epidemiology, immunology)
  • Humans
  • Immunoblotting
  • Italy (epidemiology)
  • Prevalence
  • Retrospective Studies
  • Sensitivity and Specificity
  • Statistics, Nonparametric
  • Turkey (epidemiology)

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