Serological Auto Antibodies in Health and Liver Disease in a Nigerian Population- A Preliminary Study

Introduction: Some autoantibodies are useful in the diagnosis of autoimmune liver diseases. There is dearth of information on the prevalence, pattern of autoantibodies in black population of Africans with liver diseases. To the knowledge of the authors, there is no such information among Nigerians. This study determined the prevalence, pattern and significance of serological autoantibodies among patients with liver diseases and apparently healthy individuals in Nigeria. Materials and Methods: The seroprevalence of antinuclear antibodies (ANA), antimitochondrial antibodies (AMA), anti-liver kidney microsomal antibodies (Anti-LKM-1), anti-soluble liver antigen/liver pancreas (Anti-SLA-LP), perinuclear anti-neutrophil cytoplasmic antibodies (pANCA), were determined in age and sex-matchedpatients with liver diseases and apparently healthy controls using ELISA method over a two-year period. There were one hundred and twenty six patients with liver diseases consisting of 91 (72.2%) males and 35 (27.8%) females) and 82 apparently normal control subjects, made up of 59 (72%) males and 23 (28%) females.Appropriate statistical methods were used to determine Odds ratio, Pearson Chi square and Students't-test. Significant statistical difference was specified at p<0.05. Results: The patients consisted of hepatocellular carcinoma (HCC) 77 (61.1%), liver cirrhosis 32 (25.4%), chronic hepatitis 10 (7.9%), acute viral hepatitis 4 (3.2%), alcoholic cirrhosis 1 (0.8%) and primary biliary cirrhosis 2 (1.6%). . Of all the autoantibodies analysed (126 cases and 82 controls), only AMA was significantly higher among cases compared with controls. Antimitochondrial antibodies were present in 76 (60.3%) of the cases compared with 36 (43.9%) controls (p<0.05), while ANA were present in 42 (39.3%) of cases compared with 27 (39.7%) controls (p=0.68). Anti-soluble liver antigen (anti-SLA/LP) and pANCA were absent among cases and controls. Though few in number, chronic hepatitis had the highest frequency of AMA, being positive in 9 (90%) of the 10 cases, compared to HCC, in which AMA was present in 48 (62.3%). Conclusion: The prevalence of serological autoantibodies was similarly high in both liver diseases and in health, except for AMA. Serum autoantibodies, therefore, appear to be insignificant and insufficient for the diagnosis of autoimmune liver disease in Nigerians. Other parameters should be considered whenever there is a clinical suspicion of autoimmune liver disease among Nigerians.