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Background: Detection of antinuclear antibodies (ANA) by different immunoassays (usually indirect fluorescence assay IFA) is the most common and sensitive screening test used for the diagnosis of many types of autoimmune disease such as systemic lupus erythematosus (SLE). Moreover, a high titer of ANA can be frequently found in healthy individuals, making it not a very specific marker of autoimmunity. However, the information about the prevalence of these false positive ANA in a healthy individual is not well investigated around the world particularly in Asia and MENA region including Qatar. Objectives: The aim of this study was to (i) estimate the prevalence of ANA among male healthy individuals of local and expatriate communities residing in Qatar and (ii) to evaluate the performance of a new commercial ELISA kit using two quality control parameters; analytical sensitivity (endpoint titration) and positive predictive value (PPV). Methodology: Sera collected from a total of 2965 volunteer donors of age 18 years or older, attending Hamad Medical Corporation between 2013 and 2016, were used to test for the presence of ANA IgG using Bioprobes Srl microplate ELISA kits. All positive ELISA kit results were retested using the IFA IgG for the detection of ANA nuclear staining patterns. Results: ANA prevalence among the healthy population was 0.34%, as only 10 samples out of 2965 were positive by the ANA ELISA. An additional 12 borderline samples were also detected raising the prevalence to 0.74% (22/2965). The Irani nationals had the highest prevalence of ANA with 1.83%. About 70% of the samples had a nuclear-speckled staining pattern. ELISA kit showed excellent performance efficiency, i.e., similar titration score to IFA for positive samples and high PPV (100%). Conclusion: This is the first ANA comprehensive study in the MENA region with such a large sample size. According to literature and our own literature review, the average prevalence of ANA in healthy individuals in a different part of the world is usually about 3-15%; however, in Qatar, it is only 0.34%. We recommend using the new Dia. Pro ELISA kit for ANA screening as this kit showed high efficiency for detecting ANA in comparison to the gold standard IFA assay.

Prevalence of Antinuclear Antibodies (ANA) among Healthy Individuals with Different Nationalities in Qatar