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Antibodies to soluble liver antigen in patients with various liver diseases: A multicentre study
Author(s) -
Efe Cumali,
Ozaslan Ersan,
Wahlin Staffan,
Purnak Tugrul,
Muratori Luigi,
Quarneti Chiara,
Yüksel Osman,
Muratori Paolo
Publication year - 2013
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/liv.12022
Subject(s) - medicine , autoimmune hepatitis , gastroenterology , serology , clinical significance , cirrhosis , antibody , confidence interval , antigen , immunology , hepatitis
Background 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 .