Autoimmune, Cholestatic and Biliary Disease
Quality of life and everyday activities in patients with primary biliary cirrhosis†
Article first published online: 20 NOV 2007
Copyright © 2007 American Association for the Study of Liver Diseases
Volume 46, Issue 6, pages 1836–1843, December 2007
How to Cite
Selmi, C., Gershwin, M. E., Lindor, K. D., Worman, H. J., Gold, E. B., Watnik, M., Utts, J., Invernizzi, P., Kaplan, M. M., Vierling, J. M., Bowlus, C. L., Silveira, M. G. and Bossi, I. (2007), Quality of life and everyday activities in patients with primary biliary cirrhosis. Hepatology, 46: 1836–1843. doi: 10.1002/hep.21953
Potential conflict of interest: Nothing to report.
The members of the USA PBC Epidemiology Group are as follows (in alphabetical order): Fred Askari, University of Michigan, Ann Arbor, MI; Nancy Bach, Mt. Sinai School of Medicine, New York, NY; Nathan Bass, University of California, San Francisco, CA; Gordon D. Benson, UMDNJ-Robert Wood Johnson Medical School, Camden, NJ; Andres Blei, Northwestern University, Chicago, IL; Andrea D. Branch, Mt. Sinai Medical School, New York, NY; Thomas Capozza, Scripps Clinic, La Jolla, CA; David J. Clain, Beth Israel Medical Center, New York, NY; Robert Gish, California Pacific Medical Center, San Francisco, CA; Richard Green, Northwestern University, Chicago, IL; M. Edwyn Harrison, Mayo Clinic, Scottsdale, AZ; Steven Herrine, Thomas Jefferson University, Philadelphia, PA; Emmet B. Keeffe, Stanford University, Palo Alto, CA; Natasha Khazai, University of Michigan, Ann Arbor, MI; Kris V. Kowdley, University of Washington, Seattle, WA; Edward L. Krawitt, University of Vermont, Burlington, VT; John Lake, University of Minnesota, Minneapolis, MN; Douglas LaBrecque, University of Iowa, Iowa City, IA; Velimir Luketic, Medical College of Virginia, Richmond, VA; Andrew Mason, Ochsner Clinic, New Orleans, LA; Marlyn J. Mayo, University of Texas at Southwestern, Dallas, TX; Timothy McCashland, University of Nebraska, Omaha, NE; Santiago Munoz, Albert Einstein Medical Center, Philadelphia, PA; Paul Pockros, Scripps Clinic, La Jolla, CA; Don Rockey, Duke University, Durham, NC; and Alastair D. Smith, Duke University, Durham, NC.
- Issue published online: 28 NOV 2007
- Article first published online: 20 NOV 2007
- Manuscript Accepted: 28 JUL 2007
- Manuscript Received: 25 JUN 2007
- National Institutes of Health. Grant Number: DK56839
Primary biliary cirrhosis (PBC) is generally a slowly progressive disease that may lead to cirrhosis and liver failure. However, patients with PBC often suffer from a variety of symptoms long before the development of cirrhosis that include issues of daily living that have an impact on their work environment and their individual quality of life. We therefore examined multiple parameters by taking advantage of the database of our cohort of 1032 patients with PBC and 1041 matched controls. The data were obtained from patients from 23 tertiary referral centers throughout the United States and from rigorously matched controls by age, sex, ethnicity, and random-digit dialing. The data showed that patients with PBC were more likely than controls to have significant articular symptoms, a reduced ability to perform household chores, and the need for help with routine activities. Patients with PBC rated their overall activity similar or superior to that of controls; however, more of them reported limitations in their ability to carry out activities at work or at home and difficulties in everyday activities. PBC cases also more frequently reported limitations in participating in certain sports or exercises and pursuing various hobbies; however, they did not report significant limitations in social activities. In a multivariable analysis, household income, a diagnosis of systemic lupus erythematosus, limitations in work activities, a reduction in work secondary to disability, and church attendance were independently increased in PBC cases with respect to controls. Conclusion: Our data indicate that the quality of life of patients with PBC in the United States is generally well preserved. Nevertheless, patients with PBC suffer significantly more than controls from a variety of symptoms that are beyond the immediate impact of liver failure and affect their lifestyle, personal relationships, and work activities. (HEPATOLOGY 2008.)