title: Quality of life and everyday activities in patients with primary biliary cirrhosis.
abstract: 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.
  
  
  CONCLUSIONS
  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.
authors.affiliation: Division of Rheumatology, Allergy, and Clinical Immunology, University of California, Davis, CA 95616, USA.
authors.forename: Carlo
authors.initials: C
authors.lastname: Selmi
authors.forename: M Eric
authors.initials: ME
authors.lastname: Gershwin
authors.forename: Keith D
authors.initials: KD
authors.lastname: Lindor
authors.forename: Howard J
authors.initials: HJ
authors.lastname: Worman
authors.forename: Ellen B
authors.initials: EB
authors.lastname: Gold
authors.forename: Mitchell
authors.initials: M
authors.lastname: Watnik
authors.forename: Jessica
authors.initials: J
authors.lastname: Utts
authors.forename: Pietro
authors.initials: P
authors.lastname: Invernizzi
authors.forename: Marshall M
authors.initials: MM
authors.lastname: Kaplan
authors.forename: John M
authors.initials: JM
authors.lastname: Vierling
authors.forename: Christopher L
authors.initials: CL
authors.lastname: Bowlus
authors.forename: Marina G
authors.initials: MG
authors.lastname: Silveira
authors.forename: Ilaria
authors.initials: I
authors.lastname: Bossi
mesh_terms: D000203:Activities of Daily Living; D016022:Case-Control Studies; D019992:Databases as Topic; D006801:Humans; D008105:Liver Cirrhosis, Biliary / Q000453:epidemiology*; D009749:Nutrition Surveys; D011788:Quality of Life; D014481:United States / Q000453:epidemiology