Quality of Life in Patients with Primary Biliary Cirrhosis

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Quality of Life in Patients with Primary Biliary Cirrhosis

Primary biliary cirrhosis (PBC) is a disease characterized by inflammatory destruction of the small bile ducts within the liver. PBC eventually leads to cirrhosis of the liver. The cause of PBC is unknown, but because of the presence of autoantibodies, it is generally thought to be an autoimmune disease. Other etiologies, such as infectious agents, have not been completely excluded. PBC has a worldwide prevalence of approximately 5/100,000 and an annual incidence of approximately 6/1,000,000. The prevalence and incidence appear to be similar in different regions of the world. About 90% of patients with PBC are women. Most commonly, the disease is diagnosed in patients between the ages of 40 and 60 years.The impact of primary biliary cirrhosis (PBC) on health-related quality of life (HRQOL) is poorly documented. In the current study, French researchers assessed quality of life in a group of 276 unselected patients with PBC using the Nottingham Health Profile (NHP). NHP is a generic scale that assesses six major areas commonly associated with HRQOL. Data were compared with those of a sex- and age-matched control group. The associations between NHP scores and the severity of PBC were tested. Patients (86% women) had a median age of 62 years (range 33-87). Most patients were treated with UDCA. PBC patients showed a strong statistically significant difference in energy compared to controls (respectively, 40.6 vs. 22.9, P < .0001) and had worse scores for emotional reactions (22.2 vs. 16.1, P < .005). No other differences were observed. No associations of the dimension sub-scores were found with biochemical liver tests, histological stages, or duration of the disease. Among the signs or symptoms, fatigue was the finding most often associated with the dimension subscores. Conclusions Patients with PBC feel that their overall quality of life is worse than that of the control population. This difference is mainly due to the decrease in the subscores of energy and emotional reactions, both associated with fatigue. These effects must be taken into account by clinicians when treating these patients, as they constitute the clinical outcomes that have the most impact on patients' lifestyle and adherence to treatment.08/25/04ReferenceRenée Eugénie Poupon and others. Quality of life in patients with primary biliary cirrhosis. Hepatology 40(2): 489-494. August 2004.

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