An increased risk of urinary tract infection precedes development of primary biliary cirrhosis
Open accessAbstract
Background: Primary Biliary Cirrhosis is known to be associated with Urinary Tract Infections (UTIs), but whether these precede or follow the liver disease is unclear. We have therefore attempted to determine whether UTIs are more common in people with Primary Biliary Cirrhosis (PBC) prior to their diagnosis. Methods: We conducted a case control study in the General Practice Research Database. All cases of PBC first recorded at least one year after entry to the dataset were selected along with up to 10 controls matched for age, sex. A second unmatched control group who had Chronic Liver Diseases but not PBC were chosen. The main exposures studied were the occurrence of Urinary tract infections and pyelonephritis at least one or at least five years before diagnosis. We also performed an analysis restricted to those younger than 55 at diagnosis, as we hypothesized the relationship to be stronger in the younger age group. Results: PBC is associated with UTI prior to diagnosis, OR 1.50 (CI 1.26-1.78), which was similar 5 years prior to diagnosis and after adjusting for smoking. The strongest relationships were observed in pyelonephritis exposures five years before diagnosis in cases under 55 years: adjusted odds ratios were 2.60 (1.02-6.63) in comparison with matched general population controls and adjusted odds ratios were OR 2.45 (1.02-5.59) in the comparison with chronic liver disease controls. Conclusions: We found that the association between urosepsis and PBC is specific to this disease and precedes the diagnosis of PBC in a manner not previously observed in human data. This is consistent with a causal relationship.
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Recurrent UTIs have been associated with PBC in several epidemiological studies.
“Recurrent UTIs have been associated with PBC in several epidemiological studies.62 114”
From The British Society of Gastroenterology/UK-PBC primary biliary cholangitis treatment and management guidelines (2018) · cites this paper as [114]
The Background reports that four case-control studies found an association between UTIs and PBC, and the Results report an association in this study. But the Methods define exposure as ever having had a UTI, not recurrent UTIs; the cited paper does not establish the recurrence qualifier. (LLM, conf=0.87)
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- Authors
- Varyani, F. K., West, J., & Card, T. R.
- Affiliations
- University of Nottingham (GB)
- Venue
- BMC Gastroenterology
- Published
- 2011-08-26
- Volume
- 11
- Issue
- 1
- Pages
- 95-95
- ISSN
- 1471-230X (ISSN-L)
- PMC
- PMC3175196
- OpenAlex
- W2155923274
- Cited by
- 47
- References
- 31
- Citations by year
- 2026: 3 · 2025: 2 · 2024: 3 · 2022: 1 · 2021: 1 · 2020: 2 · 2019: 2 · 2018: 4 · 2017: 5 · 2015: 4 · 2014: 3 · 2013: 5 · 2012: 9
- FWCI
- 3.86
- Type
- journal article
- Language
- en
- Open access
- gold
- doi.org
- Licence
- Locations
- BMC Gastroenterology (publishedVersion, cc-by)
- Europe PMC (PubMed Central) (publishedVersion, cc-by)
- PubMed Central (publishedVersion, cc-by)
- PubMed (publishedVersion)
- DOAJ (DOAJ: Directory of Open Access Journals) (submittedVersion, cc-by-sa)
- Edinburgh Research Explorer (University of Edinburgh) (submittedVersion, cc-by)
- Funders
- National Institute for Health and Care Research (DHCS/05/05/25)
- Medical Research Council
- Topics
- Health Sciences › Medicine › Hepatology › Liver Diseases and Immunity
- Health Sciences › Medicine › Epidemiology › Urinary Tract Infections Management
- Health Sciences › Medicine › Surgery › Pediatric Hepatobiliary Diseases and Treatments
- Keywords
- primary biliary cirrhosis, urinary tract infection, pyelonephritis, urosepsis, chronic liver disease, disease onset, causal relationship, young adults
- MeSH terms
- Adult, Female, Humans, Liver Cirrhosis, Biliary, Male, Middle Aged, Prospective Studies, Risk Factors, Urinary Tract Infections, Cohort Studies, Odds Ratio, Case-Control Studies
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