title: Antibodies to soluble liver antigen in patients with various liver diseases: a multicentre study.
abstract: 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.
authors.affiliation: Department of Gastroenterology, Numune Research and Education Hospital, Ankara, Turkey. drcumi21@hotmail.com
authors.forename: Cumali
authors.initials: C
authors.lastname: Efe
authors.forename: Ersan
authors.initials: E
authors.lastname: Ozaslan
authors.forename: Staffan
authors.initials: S
authors.lastname: Wahlin
authors.forename: Tugrul
authors.initials: T
authors.lastname: Purnak
authors.forename: Luigi
authors.initials: L
authors.lastname: Muratori
authors.forename: Chiara
authors.initials: C
authors.lastname: Quarneti
authors.forename: Osman
authors.initials: O
authors.lastname: Yüksel
authors.forename: Paolo
authors.initials: P
authors.lastname: Muratori
mesh_terms: D001324:Autoantigens / Q000276:immunology*; D004797:Enzyme-Linked Immunosorbent Assay; D006508:Hepatitis Antibodies / Q000097:blood*; D019693:Hepatitis, Autoimmune / Q000453:epidemiology* / Q000276:immunology*; D006801:Humans; D015151:Immunoblotting; D007558:Italy / Q000453:epidemiology; D015995:Prevalence; D012189:Retrospective Studies; D012680:Sensitivity and Specificity; D018709:Statistics, Nonparametric; D014421:Turkey / Q000453:epidemiology
chemical_list: D001324:Autoantigens; D006508:Hepatitis Antibodies; C046431:liver antigen LA-1