Prospective evaluation of frequency and clinical relevance of antibodies in patients with autoimmune hepatitis

Background and Aims: Antibodies to soluble liver antigen (anti-SLA) are specific serological markers of autoimmune hepatitis (AIH). We prospectively evaluated the frequency and clinical significance of anti-SLA in Turkish patients with AIH. Methods and Materials: Patients who diagnosed with AIH according to simplified scoring system during the period of January 2018 and December 2022 were included in the study. ANA, AMA, ASMA and LKM were evaluated with the IFA (Immunofluorescence Assay) method, AMAM2, LKM-1, LC-1 and SLA/LP auto-antibodies were also studied by immunoblot method. The general characteristics and outcome of patients were also recorded. Results: A total of 59 patients (49 female) with median age of 34 years (range 15-79) were included. A median follow-up time was 2 (0.3-4.1) years. ANA, SMA, LKM-1, LC-1 and AMA were detected in 66%, 27%, 5%, 1,7% and 3,4% respectively. Ten patients (17%) were serology negative. Anti- SLA were found in 12 (20%) of patients. Sex distribution, age, serum levels of ALT, total bilirubin, albumin, platelet, INR and Ig-G at diagnosis were not different in patients with and without anti-SLA. The frequency of biochemical response was significantly higher in patients with positive anti-SLA than without (100% vs. 42,6%, p < 0.001) after 3 months of therapy, but not after 12 months (100% vs. 79%, p = 0.105). Conclusion: Our data suggest that anti-SLA positive patients with AIH have similar histological and laboratory features when compared to those without anti-SLA. Patients with anti- SLA showed quicker response to immunosuppressive therapy. Keywords: Autoimmune hepatitis, Autoantibody, SLA, Diagnosis, Treatment, Prognosis