Diminished survival in asymptomatic primary biliary cirrhosis. A prospective study

Gastroenterology. 1990 Jun;98(6):1567-71. doi: 10.1016/0016-5085(90)91091-j.


Data from 73 asymptomatic patients with primary biliary cirrhosis were analyzed to determine clinical course and long-term survival. Of these, 44 entered a D-penicillamine treatment trial; 29 qualified but chose not to participate. Median follow-up was 7.6 yr (range, 2.8-12.2 yr). Liver biopsy at the initial visit showed advanced disease (fibrosis, cirrhosis) in 61% of the patients. During prospective clinical follow-up, which was available for 37 of the 44 study patients, one or more symptoms of liver disease developed in 33 (89%); esophageal varices were found in 15 (41%), and histologic progression to cirrhosis was found in 20 (67%) of the 30 precirrhotic patients. Significant (p less than 0.01) biochemical progression was reflected by a decrease in mean serum albumin concentrations and an increase in mean serum bilirubin levels in 32 patients followed for 4-6 yr. Survival data were available for all 73 patients; 17 died (11 secondary to liver failure), and 1 underwent liver transplantation. These patients had a 4-fold increase in mortality rate (p less than 0.001) compared with the U.S. population matched for age, race, and sex.

Publication types

  • Comparative Study
  • Research Support, U.S. Gov't, P.H.S.

MeSH terms

  • Adult
  • Aged
  • Bilirubin / blood
  • Female
  • Follow-Up Studies
  • Humans
  • Liver / pathology
  • Liver Cirrhosis, Biliary / blood
  • Liver Cirrhosis, Biliary / drug therapy
  • Liver Cirrhosis, Biliary / mortality
  • Liver Cirrhosis, Biliary / pathology
  • Liver Cirrhosis, Biliary / physiopathology*
  • Male
  • Middle Aged
  • Penicillamine / therapeutic use
  • Prospective Studies
  • Serum Albumin / analysis
  • Survival Rate


  • Serum Albumin
  • Penicillamine
  • Bilirubin