{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,5,10]],"date-time":"2026-05-10T22:32:35Z","timestamp":1778452355649,"version":"3.51.4"},"reference-count":32,"publisher":"Wiley","issue":"2","license":[{"start":{"date-parts":[[2021,10,12]],"date-time":"2021-10-12T00:00:00Z","timestamp":1633996800000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"funder":[{"DOI":"10.13039\/100007316","name":"Division of Cancer Prevention, National Cancer Institute","doi-asserted-by":"publisher","award":["P30 CA016059"],"award-info":[{"award-number":["P30 CA016059"]}],"id":[{"id":"10.13039\/100007316","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Liver International"],"published-print":{"date-parts":[[2022,2]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec><jats:title>Background<\/jats:title><jats:p>The natural history of patients with anti\u2010mitochondrial antibody (AMA)\u2010negative Primary Biliary Cholangitis (PBC) cirrhosis has not been well defined, with prior studies showing discordant results. Furthermore, most studies of AMA\u2010negative PBC have limited numbers of patients with cirrhosis and liver\u2010related outcomes.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>We investigated the association of AMA\u2010negative PBC and the development of death, liver\u2010related death, decompensation and hepatocellular carcinoma (HCC), in a large cohort of predominantly male patients with PBC cirrhosis assembled from the Veterans Health Administration.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>In a cohort of 521 patients with PBC cirrhosis (65 AMA\u2010negative) with a total follow\u2010up of 2504.3 person\u2010years (PY) from cirrhosis diagnosis, patients with AMA\u2010negative PBC were younger and more likely to be black but had similar rates of UDCA response. AMA\u2010negative PBC cirrhosis was associated with similar unadjusted rates of liver\u2010related death (4.6 vs 5.9 per 100 PY, <jats:italic>P<\/jats:italic>\u00a0=\u00a0.44), overall death (7.7 vs 9.6 per 100 PY, <jats:italic>P<\/jats:italic>\u00a0=\u00a0.31), decompensation (7.3 vs 5.1 per 100 PY, <jats:italic>P<\/jats:italic>\u00a0=\u00a0.12) and HCC (0.6 vs 1.0 per 100 PY, <jats:italic>P<\/jats:italic>\u00a0=\u00a0.63) to AMA\u2010positive PBC. After adjusting for confounders, AMA\u2010negative PBC cirrhosis was associated with similar rates of liver\u2010related death (sub\u2010Hazard Ratio [sHR] 1.27, 95% CI 0.71\u20102.28, <jats:italic>P<\/jats:italic>\u00a0=\u00a0.42, death [sHR] 1.24, 95% CI 0.81\u20101.90, <jats:italic>P<\/jats:italic>\u00a0=\u00a0.32), decompensation (sHR 1.05, 95% CI 0.56\u20101.98, <jats:italic>P<\/jats:italic>\u00a0=\u00a0.87) and HCC (sHR 0.48, 95% CI 0.11\u20102.10, <jats:italic>P<\/jats:italic>\u00a0=\u00a0.33) to AMA\u2010positive patients.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusion<\/jats:title><jats:p>In a cohort of predominantly male patients, AMA\u2010negative PBC cirrhosis was associated with similar rates of overall or liver\u2010related death, HCC or decompensation compared with AMA\u2010positive disease.<\/jats:p><\/jats:sec>","DOI":"10.1111\/liv.15079","type":"journal-article","created":{"date-parts":[[2021,10,8]],"date-time":"2021-10-08T11:31:12Z","timestamp":1633692672000},"page":"384-393","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":21,"title":["Rates of decompensation, hepatocellular carcinoma and mortality in AMA\u2010negative primary biliary cholangitis cirrhosis"],"prefix":"10.1111","volume":"42","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-2002-9682","authenticated-orcid":false,"given":"Binu V.","family":"John","sequence":"first","affiliation":[{"name":"Division of Hepatology Bruce W Carter VA Medical Center Miami Florida USA"},{"name":"Division of Digestive Health and Liver Diseases University of Miami Miller School of Medicine Miami Florida USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Bassam","family":"Dahman","sequence":"additional","affiliation":[{"name":"Department of Health Behavior and Policy Virginia Commonwealth University Richmond Virginia USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Yangyang","family":"Deng","sequence":"additional","affiliation":[{"name":"Department of Health Behavior and Policy Virginia Commonwealth University Richmond Virginia USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Nidah S.","family":"Khakoo","sequence":"additional","affiliation":[{"name":"Department of Medicine Jackson Memorial Hospital Miami Florida USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Tamar\u00a0H.","family":"Taddei","sequence":"additional","affiliation":[{"name":"Section of Digestive Diseases Yale School of Medicine New Haven Connecticut USA"},{"name":"VA Connecticut Healthcare System West Haven Connecticut USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"David E.","family":"Kaplan","sequence":"additional","affiliation":[{"name":"Division of Gastroenterology and Hepatology University of Pennsylvania Philadelphia Pennsylvania USA"},{"name":"Division of Gastroenterology and Hepatology Corporal Michael J. 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