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Natural history and prognostic factors of primary biliary cirrhosis in Taiwan: a follow-up study up to 18 years

Authors

  • Chien-Wei Su,

    1. Division of Gastroenterology, Department of Medicine, Taipei Veterans General Hospital, Taipei, Taiwan
    2. Institute of Clinical Medicine, National Yang-Ming University, Taipei, Taiwan
    3. Faculty of Medicine, National Yang-Ming University, Taipei, Taiwan
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  • Hung-Hsu Hung,

    1. Division of Gastroenterology, Department of Medicine, Taipei Veterans General Hospital, Taipei, Taiwan
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  • Teh-Ia Huo,

    1. Division of Gastroenterology, Department of Medicine, Taipei Veterans General Hospital, Taipei, Taiwan
    2. Faculty of Medicine, National Yang-Ming University, Taipei, Taiwan
    3. Institute of Pharmacology, National Yang-Ming University, Taipei, Taiwan
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  • Yi-Hsiang Huang,

    1. Division of Gastroenterology, Department of Medicine, Taipei Veterans General Hospital, Taipei, Taiwan
    2. Institute of Clinical Medicine, National Yang-Ming University, Taipei, Taiwan
    3. Faculty of Medicine, National Yang-Ming University, Taipei, Taiwan
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  • Chung-Pin Li,

    1. Division of Gastroenterology, Department of Medicine, Taipei Veterans General Hospital, Taipei, Taiwan
    2. Faculty of Medicine, National Yang-Ming University, Taipei, Taiwan
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  • Han-Chieh Lin,

    1. Division of Gastroenterology, Department of Medicine, Taipei Veterans General Hospital, Taipei, Taiwan
    2. Faculty of Medicine, National Yang-Ming University, Taipei, Taiwan
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  • Pui-Ching Lee,

    1. Division of Gastroenterology, Department of Medicine, Taipei Veterans General Hospital, Taipei, Taiwan
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  • Shou-Dong Lee,

    1. Division of Gastroenterology, Department of Medicine, Taipei Veterans General Hospital, Taipei, Taiwan
    2. Faculty of Medicine, National Yang-Ming University, Taipei, Taiwan
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  • Jaw-Ching Wu

    1. Institute of Clinical Medicine, National Yang-Ming University, Taipei, Taiwan
    2. Department of Medical Research and Education, Taipei Veterans General Hospital, Taipei, Taiwan
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Correspondence
Jaw-Ching Wu, MD, PhD, Institute of Clinical Medicine, National Yang-Ming University, Taipei, Taiwan
Tel: +886 2 2871-2121, ext. 3218
Fax: +886 2 2874 5074
e-mail: jcwu@vghtpe.gov.tw

Abstract

Purpose: The natural history of primary biliary cirrhosis (PBC) has been little studied in Asia. We conducted a Taiwanese cohort study on the natural history of PBC and analysed the prognostic factors.

Methods: This study enrolled 96 consecutive PBC patients between 1985 and 2006 to evaluate the baseline characteristics and outcomes.

Results: There were 74 females and 22 males. Eighty-five were positive for antimitochondrial antibodies in sera, and 11 were negative. The clinical manifestations and prognosis were similar between these two groups. In a median follow-up of 47.5±55.8 months, 27 patients died. Multivariate analysis indicated that the independent prognostic factors were serum albumin (P=0.021), creatinine (P=0.033) and ursodeoxycholic acid treatment (P=0.008). Besides, 42 patients developed adverse outcomes. Albumin (P<0.001), bilirubin (P=0.019) and prothrombin time (PT) (P=0.010) were significant factors. Moreover, a Mayo risk score <5, a Model for End-Stage Liver Disease (MELD) score <6, a Child–Pugh stage A and early liver histology were associated with favourable outcomes.

Conclusion: Serum albumin, bilirubin and PT were independent prognostic factors of adverse outcomes for Taiwanese PBC patients. Besides, the Mayo risk score, the MELD score, the Child–Pugh stage and liver histology were also validated to predict survival.

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