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Prognostic implications of antibodies to Ro/SSA and soluble liver antigen in type 1 autoimmune hepatitis
Author(s) -
MontanoLoza Aldo J.,
Shums Zakera,
Norman Gary L.,
Czaja Albert J.
Publication year - 2012
Publication title -
liver international
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.873
H-Index - 110
eISSN - 1478-3231
pISSN - 1478-3223
DOI - 10.1111/j.1478-3231.2011.02502.x
Subject(s) - antibody , autoimmune hepatitis , antigen , medicine , immunology , panel reactive antibody , hepatitis , anti nuclear antibody , liver transplantation , human leukocyte antigen , autoantibody , transplantation
Background: Antibodies to soluble liver antigen are frequently co‐expressed with antibodies to ribonucleoprotein/Sjögren's syndrome A (Ro/SSA) in autoimmune hepatitis.Aims: Our goals were to evaluate the prognostic implications of antibodies to Ro/SSA in type 1 autoimmune hepatitis and to determine their independence from antibodies to soluble liver antigen.Methods: Three hundred and seventy‐six serum samples from 170 patients were tested by enzyme immunoassays.Results: Sixty‐five patients (38%) had antibodies to Ro52; 11 patients (6%) had antibodies to Ro60; and 27 patients had antibodies to soluble liver antigen (16%). Twenty‐six patients with antibodies to Ro52 had antibodies to soluble liver antigen (40%), and 26 patients with antibodies to soluble liver antigen had antibodies to Ro52 (96%). Patients with antibodies to Ro52 and antibodies to soluble liver antigen had a higher frequency of human leucocyte antigen (HLA) DRB1 * 03 (78 vs 50%, P =0.05) and lower occurrence of HLA DRB1 * 04 (22 vs 57%, P =0.01) than patients with antibodies to Ro52 alone. Antibodies to Ro52 alone [hazard ratio (HR), 2.90; 95% confidence interval (CI), 1.18–7.14, P =0.02] and antibodies to Ro52 in conjunction with antibodies to soluble liver antigen (HR, 2.98; 95% CI, 1.07–8.43, P =0.04) were independently associated with the development of cirrhosis and hepatic death or liver transplantation.Conclusions: Antibodies to Ro52 alone and antibodies to Ro52 in conjunction with antibodies to soluble liver antigen are independently associated with a poor prognosis in type 1 autoimmune hepatitis. The prognostic implications ascribed to antibodies to soluble liver antigen may reflect their almost invariable concurrence with antibodies to Ro52.