抗可溶性肝抗原/肝胰抗原抗体阳性的肝病患者临床与实验室特征

目的研究肝功能异常伴抗可溶性肝抗原／肝咦抗原（SLA／LP）抗体阳性患者临床与实验室特点。方法收集肝功能异常患者血清5500例，分别完成相关自身抗体的检测。结果8例（0．15％）患者检测出sLA／LP抗体阳性，女性6例，以中老年女性为主，男性2例，年龄分别为27岁和33岁，8例中6例无甲、乙、丙、丁、戊型等病毒性肝炎现症感染证据，2例分别伴乙、丙型肝炎病毒标志物，无现症感染证据。8例中7例已发展至肝硬化，除sLA／LP抗体阳性外，抗核抗体均为阳性，部分患者伴抗平滑肌抗体，抗线粒体抗体，抗线粒体抗体亚型-丙酮酸脱氢酶复合物阳性。结论sLA／LP抗体在所检测患者中阳性率较低，以女性患者为主，多数临床与实验室特点符合自身免疫性肝炎特征，女性患者慢性肝病原因未名者应检测此抗体。     

原发性胆汁性肝硬化患者的免疫学特点分析

目的 分析原发性胆汁性肝硬化(PBC)出现的自身抗体等免疫学指标及其临床意义。 方法对3000例肝功能异常患者采用间接免疫荧光法检测抗核抗体(ANA)、抗线粒体抗体(AMA)、抗平滑肌抗体(SMA)和抗肝肾微粒体抗体(抗-LKM)等,并对ANA和AMA亚型及抗可溶性肝抗原/肝胰抗原(抗-SLA/LP)、LKM-1和抗肝特异性胞浆抗原型1抗体(抗-LC-1)等肝脏疾病相关的自身抗体进行了检测。结果 3000例肝病患者中,PBC 52例占1.7％。PBC患者的AMA和AMA-M2抗体均为阳性,52例PBC中,94.0％呈AMA高滴度(≥1:320)阳性,79.0％M2>200 RU/L,78.0％ANA阳性。ANA的主要荧光模式为细胞核膜型、细胞核点型和着丝点型。少见的荧光模式有抗干燥综合征A/B(SS-A/SS-B)、细胞核均质型、核仁型及颗粒型等。PBC患者免疫球蛋白M、碱性磷酸酶和γ-谷氨酰转肽酶高于乙型肝炎肝硬化患者;其白细胞介素(IL)-6、IL-10、肿瘤坏死因子α和干扰素γ水平高于正常人。5例表现为自身免疫性肝病重叠综合征,其中2例抗-SLA/LP阳性,提示PBC与自身免疫性肝炎(AIH)3型的重叠;1例抗-LKM-1阳性,提示PBC与AIH 2型的重叠;2例ANA阳性,且肝活体组织检查证实存在AIH和PBC的病理改变,提示为PBC与AIH 1型的重叠综合征。 结论 PBC在我国肝病患者中约占1％~2％。临床已出现典型症状者一     

抗纤维肌动蛋白抗体对自身免疫性肝炎Ⅰ型的诊断价值

目的探讨抗纤维肌动蛋白抗体(AFA)对自身免疫性肝炎(AIH)Ⅰ型的诊断价值。方法收集163例AIH-Ⅰ型、5例AIH-Ⅱ型、26例AIH-Ⅲ型、26例原发性胆汁性肝硬化(PBC)、5例原发性硬化性胆管炎(PSC)、2例重叠综合征(AIDOS)及95例其他类型肝病患者的临床资料,另外收集197例健康献血者作为对照组,采用酶联免疫吸附测定法(ELISA)分别检测上述标本的AFA和抗平滑肌抗体(ASMA),对检测结果进行统计分析。结果以浓度≥30 U/L为阳性标准判断,AFA与ASMA检测AIH-Ⅰ型患者的阳性率无统计学差异(χ~2=0.37,P=0.54),但ASMA检测AIH-Ⅲ型和乙型肝炎患者的阳性率高于AFA,差异有统计学意义(χ~2值分别为5.65、6.37,P值分别为0.02、0.01)。AFA对ASMA≥20 U/L的AIH患者检出率≥98.27%,检测结果与ASMA的浓度有显著相关性(r=0.88,95%CI:0.66~0.99,P=0.00)。AFA与ASMA检测AIH-Ⅰ型患者的敏感性相近(71.78%vs68.71%),但AFA的特异性(83.87%vs 54.84%)和Youden指数(0.56 vs 0.24)更高。结论与ASMA相比,AFA检测AIH-Ⅰ型患者敏感性相近,但特异性和Youden指数更高,AFA对AIH-Ⅰ型的诊断价值优于ASMA。     

酶联免疫法检测自身免疫性肝炎I型抗纤维肌动蛋白抗体的评估

目的对使用酶联免疫吸附试验(ELISA)检测自身免疫性肝炎(autoimmune hepatitis,AIH)Ⅰ型患者抗纤维肌动蛋白抗体(AFA)进行评估分析。方法收集163例AIH-Ⅰ型、15例AIH-Ⅱ型、36例AIH-Ⅲ型患者临床资料及血清标本,采用ELISA法检测患者的AFA,同时采用间接免疫荧光法(IFA)检测患者的AFA和抗平滑肌抗体(ASMA)作为对照,对检测结果进行统计学分析。结果以IFA≥1∶320、ELISA≥30 U为阳性判断标准,除AFA-ELISA与ASMA-IFA检测AIH-Ⅱ型的阳性例数差异有统计学意义外(P=0.03),AFA-ELISA与AFA-IFA、ASMA-IFA比较,检测其他AIH各型患者阳性例数差异均无统计学意义(P﹥0.05)。AFAELISA与AFA-IFA检测AIH-Ⅰ型的相关性比ASMA-IFA更好(r=0.97 vs 0.52)。AFA-ELISA与AFA-IFA相比,检测AIH-Ⅰ型有稍高的敏感性(76.07%vs 71.17%)和略低的特异性(72.55%vs 78.43%);AFA-ELISA与ASMA-IFA相比,检测AIH-Ⅰ型有更高的敏感性和特异性(76.07%vs 64.42%,72.55%vs 60.78%);AFA-ELISA检测AIH-Ⅰ型的约登指数与AFA-IFA相近(0.49 vs 0.50),比ASMA-IFA高(0.49 vs 0.25)。AFA-ELISA检测AIH-Ⅰ型的ROC面积为0.86,当浓度为54.06 U/ml时检测的敏感性和特异性最好。结论 AFA-ELISA检测AIH-Ⅰ型的敏感性和特异性与AFA-IFA相近,但操作更方便,与ASMA-IFA的敏感性相近,但特异性更好。AFA-ELISA可作为AIH-Ⅰ型较好的筛查方法。     

慢性肝病中抗肝抗原自身抗体的检测

目的　探讨中国人不同病因所致慢性肝病患者中抗肝抗原自身抗体的存在状况及自身免疫性肝病的自身抗体特征。方法　 166例肝功能异常患者分为 6组 :自身免疫性肝炎 (AIH ) 12例、原发性胆汁性肝硬化 (PBC) 2 0例、原发性硬化性胆管炎 (PSC)13例、HBV组 66例、HCV组 2 2例、肝豆状核变性 (HDL) 3 9例。用间接免疫荧光法检测抗核抗体 (ANA)、平滑肌抗体 (SMA)、抗肝肾微粒抗体I型抗体 (anti LKM1)、抗线粒体抗体 (AMA)和抗中性粒细胞胞浆抗体 (ANCA) ,免疫印迹法检测抗肝细胞胞溶质抗原 1型抗体 (anti_LC1)、抗可溶性肝抗原 /肝胰抗原抗体 (anti_SLA/LP)、抗肝肾微粒抗体 1型 (anti_LKM1)、AMA_M2亚型等多种肝抗原自身抗体。结果　 166例中ANA、AMA、M_2、pANCA阳性率在 7组中有显著差异 (P <0 .0 1)。PBC中AMA、M 2阳性检出率均为 10 0 % ,PSC中pANCA阳性检出率为 5 3 8% ,Fisher精确检验在a =0 .0 0 2水准与其他各组比较有显著差异。AIH与PBC的ANA阳性率分别为10 0 %和 60 % ,Fisher精确检验在a =0 .0 0 2水准二者无显著差异。与其他各组比较有显著差异。在AIH组SMA阳性率为 2 5 % ,LKM 1、LC 1、SLA/LP阳性率均为 8.3 % ,统计学处理与其他组无显著差异 (P >0 0 5 ) ,可能与病例少有关。PBC中分别有 1     

抗Ro52抗体与Ⅰ型自身免疫性肝炎患者病情的相关性研究

[目的]探究抗Ro52抗体与I型自身免疫性肝炎患者病情的相关性。[方法]选取68例于2014年8月之2016年5月入我院诊治的Ⅰ型自身免疫性肝炎(autoimmune hepatitis,AIH)患者,运用免疫印迹法检测患者血清抗Ro52抗体,依据检测结果,将所有患者分为抗Ro52抗体阳性组(26例)和抗Ro52抗体阴性组(42例),收集2组患者的抗核抗体(ANA)滴度、抗可溶性肝原(抗SLA/LP)抗体、抗Ro60抗体、肝病相关并发症、肝外自身免疫性疾病、免疫球蛋白等资料,并进行对比。[结果]2组AIH患者的ANA抗体滴度主要分布于1:320~1:1 000之间;在抗Ro52抗体阳性组中,有7例合并有抗SLA/LP抗体阳性、有16例合并有抗Ro60抗体阳性;在肝病相关并发症方面,抗Ro52抗体阳性组发生率要高于阴性组,但差异无统计学意义(χ~2=0.11,P=0.75);在肝外自身免疫性疾病方面,抗Ro52抗体阳性组发生率显著高于阴性组,差异具有统计学意义(χ~2=5.13,P=0.02);在免疫球蛋白水平方面,抗Ro52抗体阳性组IgG水平显著高于阴性组,差异具有统计学意义(t=3.67,P0.01)。[结论]抗Ro52抗体阳性的Ⅰ型AIH患者合并有肝病相关并发症和肝外自身免疫性疾病的可能性较高,Ⅰ型AIH的发病可能与抗Ro52抗体和IgG共同作用有关。     

自身免疫性肝炎患者自身抗体的测定及意义

目的:探讨自身抗体测定对诊断自身免疫性肝炎的临床意义．方法:采用间接免疫荧光法(IIF)检测47例自身免疫性肝炎患者、158例非自身免疫性肝炎患者及40例健康体检者体内抗核抗体(ANA)、抗平滑肌抗体(SMA)、抗中性粒细胞胞质抗体(ANCA)、抗线粒体抗体(AMA)等自身抗体,ELISA法检测抗MPO抗体,并对结果进行回顾性分析．结果:ANA、SMA及ANCA检出率的比较,结果显示AIH中阳性率最高为SMA(66．0％, 31／47),而非AIH中则为6．3％(10／158),两组差异有非常显著性意义(P<0．01)．经X2检验, SMA、AMA和MPO抗体检测在AIH与PBC中,均有非常显著性意义(P<0．01)．AIH各型自身抗体检测结果表明,AIH-Ⅰ与ANA、SMA和ANCA相关,AIH-Ⅱ与LKM相关,而AIH=Ⅲ与SLA和ANCA相关．结论:血清自身抗体的检测对诊断、治疗和阻止自身免疫性肝炎的发展有着十分重要作用,对提高AIH在临床上同其他肝病鉴别诊断和治疗有着非常重要的意义．     

儿童自身免疫性肝炎的诊治进展

自身免疫性肝炎(AIH)是一种进行性炎症性肝病,儿童AIH发病率近年来逐步上升。AIH可分为两种类型:抗核抗体和(或)平滑肌抗体和(或)抗可溶性肝抗原抗体阳性的AIH-1、抗肝-肾微粒体1型和(或)抗肝细胞溶质1型抗体阳性的AIH-2,AIH-2主要见于儿童。正常儿童少见自身抗体阳性,因此儿童AIH诊断时对自身抗体滴度的要求低于成人标准,但儿童AIH疾病进展比成人期更快,因此确诊后应该立即开始治疗。成人AIH诊断评分系统不适用于儿科患者,尤其不适于区分AIH和自身免疫性硬化性胆管炎。     

自身免疫性肝炎与肝源性糖尿病的相关性研究

目的分析自身免疫性肝炎(autoimmune hepatitis,AIH)的血糖变化,探讨肝源性糖尿病(hepatogenous diabetes,HD)的发病机制。方法回顾性分析2000年1月-2008年4月在天津医科大学总医院确诊的Ⅰ型AIH患者的临床资料,并就空腹血糖水平与乙型病毒性肝炎(viral hepatitis type B,HBV)对比分析。结果 75例AIH患者中,38例出现高血糖(50.67%);在无肝硬化组及合并肝硬化肝功能Child-Pugh分级A级组中,AIH高血糖的发生率分别为33.33%和51.16%,高于HBV患者,二者差异具有统计学意义(P<0.05)。合并肝硬化肝功能Child-Pugh分级处于B级或C级时,二者高血糖的发生率差异无统计学意义(P>0.05)。结论 AIH患者较易出现高血糖,临床AIH患者常规血糖检查具有重要意义。AIH免疫紊乱导致肝炎的同时,也可能引起自身免疫性胰腺炎,可能是HD的发生机制之一。     

自身免疫性肝炎的最新概念及其分型

近年来,除ANA、SMA、AMA外又相继发现了一些新的自身抗体:LSP、LMA、LKM-1、ASGPR、LCI、SLA、LP抗体等,随着对自身免疫性肝炎(AIH)的亚型分类、遗传背景与发病、与HCV感染的关系等的阐明,得出了该病的新概念:AIH是一组慢性肝炎综合征,病人呈现肝脏本身的免疫耐受性减低,不能正确识别自身肝组织成分而产生自身免疫反应,引起以门脉周围病变为主的非自限性肝炎。目前将其分为3型:①AIH-Ⅰ型,即经典型,主要为ANA或SMA(或actin抗体)阳性,最近又细分为Ⅰa型(ANA阳性)与Ⅰb型(actin抗体阳性);②AIH-Ⅱ型主要为LKM-1抗体阳性,或同时有LCI抗体,近又细分为Ⅱ     

Significance of antibodies to soluble liver antigen/liver pancreas: a large French study

Background: Antibodies to soluble liver antigen (SLA)/liver pancreas (LP) are generally considered as highly specific diagnostic markers of type 1 auto‐immune hepatitis (AIH‐1), and are particularly useful in patients without conventional antibodies. However, the presence of anti‐SLA/LP in type 2 auto‐immune hepatitis (AIH‐2), primary sclerosing cholangitis (PSC) and hepatitis C has recently been reported. The aim was thus to describe the characteristics of anti‐SLA/LP‐positive patients in the largest series reported to date. Methods: Sera were selected from the period between 1998 and 2005, based on the presence of antibodies to SLA/LP detected by two methods. The clinical status of patients was determined from their medical records. Results: Eighty‐one anti‐SLA/LP‐positive patients with available clinical data were included: 89% (72/81) had a diagnosis of AIH‐1, including 10 (12%) associated with cholestatic diseases (primary biliary cirrhosis in seven cases and PSC in three cases). Six patients (7%) suffered from another liver disease: hepatitis C (n=3) and drug‐induced hepatitis (n=3). No specific diagnosis was made in three patients. Conclusions: Antibodies to SLA/LP are of a major diagnostic value for AIH‐1, including paediatric forms and overlap syndromes with cholestatic diseases, but are not found in association with anti‐liver/kidney/microsome type 1 or antibodies to liver cytosol type 1. They are rarely present in other liver diseases such as hepatitis C and drug‐induced hepatitis.     

血清腺苷脱氨酶和淀粉样蛋白A辅助诊断自身免疫性肝炎患者临床价值分析*

目的 分析应用血清腺苷脱氨酶(ADA)和淀粉样蛋白A(SAA)辅助诊断自身免疫性肝炎(AIH)患者的临床价值。方法 2017年1月～2018年12月我院收治的AIH患者60例,乙型肝炎、丙型肝炎和酒精性肝炎患者98例和同期健康人100例,采用胶乳比浊法检测血清SAA,采用谷氨酸脱氢酶偶联速率法检测血清ADA,采用间接免疫荧光法检测血清抗核抗体(ANA),采用免疫印迹法检测血清抗肝肾微粒体Ⅰ型(LKM-1)、抗肝细胞浆抗体Ⅰ型(LC-1)、抗可溶性肝抗原/肝胰抗原(SLA/LP)。 结果 AIH组血清SAA水平为(58.7±6.2)mg/L,显著高于非AIH组【(12.3±2.5)mg/L,P<0.05】或健康人【(6.3±1.2)mg/L,P<0.05】,血清ADA水平为(88.4±10.1)U/L,显著高于非AIH组【(17.7±3.0)U/L,P<0.05】或健康人【(10.3±2.1)mg/L,P<0.05】;AIH组血清ANA、抗LKM-1和抗SLA/LP阳性率分别为68.3%、16.7%和11.7%,而仅非AIH组血清ANA阳性率为42.9%(P<0.05); 在本组AIH患者,血清ANA诊断的灵敏度、特异度和准确性分别为68.3%、57.1%和60.0%,而以血清SAA＞52.1 mg/L或ADA＞77.9 U/L为截断点,对血清ALT升高者在排除常见病因引起的肝功能损伤后,其辅助诊断AIH的灵敏度、特异度和准确性分别被提高到76.7%、89.8%和70.4%。结论 对血清自身抗体阴性者,在排除常见的引起肝损伤的病因后,血清ADA或/和SAA异常升高,有助于对AIH的诊断,值得进一步探讨。     

Identification of T cell epitopes on soluble liver antigen in Chinese patients with auto‐immune hepatitis

Aim: To identify soluble liver antigen (SLA)‐specific dominant epitopes and analyse the correlation between SLA‐specific T cell response and the status of the disease. Methods: A cross‐sectional analysis of SLA‐specific T cell responses to 54 overlapping peptides covering the entire SLA sequence was performed using an interferon (IFN)‐γ ELISpot assay in 31 patients with auto‐immune hepatitis (AIH)‐1, 15 patients with primary biliary cirrhosis, 16 hepatitis B virus, seven hepatitis C virus infection and 10 healthy subjects, in order to assess the correlation between SLA‐specific T cell responses and the clinical outcome. Results: Soluble liver antigen‐specific IFN‐γ responses in AIH were significantly more frequent in AIH patients (58.1%) than those in controls (6.7% in PBC, P=0.001; 4.3% in hepatitis B/C, P<0.001 and 0% in healthy subjects, P=0.0015). Among 31 AIH patients, the frequency of recognition and the magnitude of response to SLA peptides in anti‐SLA antibody‐positive patients were higher and stronger than those negative for anti‐SLA antibodies (P=0.02 and 0.037 respectively). We further analysed T‐cell restriction and found that six individual SLA peptides (4, 9, 11, 12, 41 and 44) were recognized by CD4 T cells, and the most frequently recognized peptides were peptides 12 (61.1% of participants), followed by peptide 4 and peptide 44 (55.6 and 38.9% respectively). Moreover, a positive association was found between the breadth of recognition of SLA peptides and the indices of liver damage. Conclusion: T cell response to SLA in Chinese patients with AIH is broad and associated with hepatocyte damage.     

Genetic association of autoimmune hepatitis and human leucocyte antigen in German patients

INTRODUCTION Autoimmune hepatitis (AIH) is characterized by portal lymphatic infiltrates on liver histology and in most patients with the occurrence of autoantibodies such as antinuclear, smooth muscle antibody-positive (ANA/ SMA, type 1), liver-kidney microsomal antibody-positive (LKM-1), and soluble liver antigen/liver-pancreas antigen (SLA/LP) antibodies. Untreated, the disease usually runs an unfavorable course with 5 year survival rates of 50% and 10 year survival rates between…     

Fine specificity of autoantibodies to soluble liver antigen and liver/pancreas

Autoantibodies to soluble liver antigen and liver pancreas (SLA/LP) have been described as specific markers for Autoimmune Hepatitis (AIH), occurring in about 20% of patients with AIH. The high degree of specificity for SLA/LP in autoimmune liver disease suggests a possible role in its pathogenesis. This study aims to map the exact epitope(s) recognized by SLA/LP autoantibodies and to assess the role of molecular mimicry between microbial antigens and self-epitopes. Using SLA/LP-reactive sera of 18 individual AIH patients and a pool of 15 patient sera, we found the dominant immune reactivity directed to peptide p395-414 and a less prominent immune response to 2 other epitopes adjacent to the dominant epitope. Immunodominance of peptide p395-414 was confirmed by absorption experiments. The SLA/LP autoantibodies of all tested AIH patients were mainly of the IgG1 type, suggesting that SLA/LP autoantibodies may arise by a common and specific underlying immune stimulus. Based on sequence homologies of the SLA/LP antigenic region with viral proteins, it was hypothesized that molecular mimicry may drive autoimmunity to SLA/LP. However, the homologous virus-derived peptides were not recognized by SLA/LP autoantibodies. Similarly, the only known procaryotic homologue, MJ0610 of Methanococcus jannaschii, was only weakly recognized by SLA/LP-positive sera. Thus, no evidence could be found for molecular mimicry being the causative mechanism for the development of SLA/LP autoantibodies. In conclusion, the exquisite epitope specificity and IgG subtype are evidence for the maturity of the SLA/LP autoantibody response; a specific autoantigen-driven process underlying the immunopathogenesis is likely.     

Clinical significance of autoantibodies to soluble liver antigen in autoimmune hepatitis.

BACKGROUND/AIMS: Classification of autoimmune hepatitis (AIH) into different subgroups according to autoantibody status has been proposed: type I (ANA/SMA), type II (LKM-1) and type III (anti-SLA). However, whether type III AIH forms a clinically distinct disease entity remains controversial. The aim of this study was to evaluate the subclassification of AIH into ANA/SMA and anti-SLA positive patients with regard to clinical, biochemical and histologic differences. METHODS: Ninety-seven consecutive patients with a well-documented long-term course of AIH with ANA/SMA and/or anti-SLA autoantibodies were studied. Clinical, biochemical and histological features of patients with ANA/SMA and/or anti-SLA autoantibodies were compared in a secondary analysis of data acquired prospectively. RESULTS: Anti-SLA autoantibodies were found in 21.6% of patients. Anti-SLA-positive patients tended to have lower transaminases (mean: 153 vs. 247 IU/l), gamma-globulins (25 vs. 31%) and bilirubin (1.8 vs. 3.3 mg/dl) in comparison to ANA/SMA positive patients, but there was a large overlap. HLA-type A1 B8 was more frequent in anti-SLA positive patients, while there was no difference in HLA DR3 and DR4 allotype. Response to immunosuppressive therapy was excellent, but relapse occurred frequently. Diagnosis of anti-SLA positive AIH was often delayed (mean: 68 months from first elevation of transaminases) since testing for anti-SLA autoantibodies is currently not generally available. CONCLUSIONS: ANA/SMA and anti-SLA positive patients share most clinical, biochemical, histologic and prognostic features. Distinction between type I and type III AIH is therefore clinically not helpful. However, testing for anti-SLA autoantibodies helps in the diagnosis of AIH in many patients who may otherwise be misdiagnosed.     

Prognostic Implications of Antibodies to Soluble Liver Antigen in Autoimmune Hepatitis: A PRISMA-Compliant Meta-Analysis

Prognostic evaluation is important for the management of patients with autoimmune hepatitis (AIH). Although some autoantibodies have been associated with disease activity and outcomes, the implication of antibodies to soluble liver antigen (anti-SLA) remains controversial.To conduct a meta-analysis of observational studies which addressed differences in clinical characteristics by anti-SLA status in patients with AIH.Three databases PUBMED, EMBASE, and OVID were systemically searched up to January 2015 using the terms “soluble liver antigen” or “liver-pancreas antigen” and “autoimmune hepatitis” with restriction to English-language.Studies were included if at least 50 patients with objective diagnosis of AIH were enrolled, anti-SLA detection was performed for the patients, and prognostic outcomes and/or disease severity were reported.Two investigators independently reviewed retrieved literature and evaluated eligibility. Discrepancy was resolved by discussion and a third investigator. Quality of included studies was evaluated using Newcastle-Ottawa Quality Assessment Scale (NOS). Data were pooled using fixed-effect or random-effect models.Prognostic outcomes included death from hepatic failure or requirement for liver transplantation, and responses to immunosuppressive therapy regarding remission or relapse. Results were combined on the odds ratio (OR) or standardized mean difference (SMD) scales.Eight studies were enrolled in this study, involving a total of 1297 AIH patients among whom 195 with anti-SLA. Pooled serum AST levels tended to be lower in anti-SLA seropositive patients. The presence of anti-SLA conferred 3.1-fold increased risk of hepatic death in AIH patients. The remission rates were comparable between anti-SLA seropositive and seronegative AIH patients, while anti-SLA positivity was associated with nearly 2-fold increased risk of relapse after drug withdrawal. Human leukocyte antigen (HLA) allotype DR3 was positively associated with anti-SLA.Antibodies to SLA may be an indicator of increased risks of hepatic death and treatment relapse for AIH patients. Our findings suggest that the anti-SLA seropositive patients should be maintained indefinitely on individually adjusted medication to improve their prognosis.