Autoantibodies profile in autoimmune liver diseases and chronic viral hepatitis.

Despite their low prevalence, autoimmune liver diseases (AILD) cause liver cirrhosis, progress and leads to mortality from liver failure. Autoantibodies are confirmed to have significance in the early screening of AILD patients, especially in those who are asymptomatic before onset of clinical signs. This study aimed to assess levels of liver autoantibodies and their association with clinical manifestations of autoimmune liver diseases and chronic viral hepatitis (CVH) patients. This case-control study included 50 patients (case group of 25 patients with AILD and control group of 25 patients with CVH). They were investigated for presence of antibodies against LKM-1, AMA-M2, PML, M2-3E (BPO), gp210, Sp100, LC-1, Ro52 and SLA/LP using the line immune blot technique, and for the presence of antinuclear antibodies (ANA), as non-organ specific autoantibodies, using indirect immunofluorescence technique. Specific autoantibodies were detected in all AILD cases and some of their levels were significantly higher when compared with CVH group. Among AILD patients, 52% were positive for ANA, whereas 61.1% of chronic hepatitis C and 28.6% of chronic hepatitis B patients were positive for ANA with no significant difference (p=0.3). In conclusion, early diagnosis of autoimmune liver diseases has been linked to assessment of autoantibodies, allowing for prompt therapeutic intervention to stop the progression of liver cirrhosis and the accompanying complications.

Role of Candida Albicans Germ Tube Antibody in Diagnosis of Invasive Candidiasis in End Stage Liver Disease Patients.

Candida species are the leading cause of invasive fungal infections and a common cause of hospital-acquired bloodstream infections. Invasive candidiasisis a highly lethal infection associated with mortality rates between 40 and 60 %. This study was conducted with aim of assessing the role of Candida albicans germ tube antibody (CAGTA) level in the early diagnosis of invasive candidiasis and in monitoring the efficacy of antifungal drugs in patients with end stage liver disease. Sixty two end stage liver disease patients were included in this study. Candida albicans germ tube antibody (CAGTA) test was done for all cases by indirect immunofluorescence technique, and it was positive with (titre ≥ 1/160) in 18 cases including the 10 blood culture positive cases. Compared to positive blood culture, the sensitivity, specificity, negative predictive value, positive predictive value and accuracy of CAGTA test were 100%, 84.6 %, 55.6 %, 100 % and 73.3 % respectively. Candida albicans germ tube antibody (CAGTA) test is sensitive and specific test, that can be used for early diagnosis of invasive candidiasis and in monitoring the effect of treatment with antifungal drugs in end stage liver disease patients.