PRIMARY BILIARY-CIRRHOSIS - IS (AND HOW MUCH OF) THE PATHOLOGY PREVENTABLE

Primary biliary cirrhosis (PBC) is a chronic, progressive cholestatic liver disease, which is invariably fatal. Circumstantial and indirect evidence suggests that autoimmune mechanisms have a role in the pathog enesis of PBC. Antimitochondrial antibodies (AMA) are highly sensitive and specific markers that can predict the development of the disease in a healthy individual. Long-term administration of ursodeoxycholic a cid (UDCA), a naturally occurring bile acid, safely slows the progress ion of PBC, delays the need for Liver transplantation, and postpones d eath. An effort should be made to identify the patients with PBC in th e asymptomatic stage by the presence of AMA and to conduct a clinical trial in order to assess the benefit of long-term administration of UD CA on the prevention of the overt disease in these individuals.