#185 - Geographic Heterogeneity in Primary Biliary Cholangitis Across Latin America: Results From Allatin Cohort
Year: 2026
Type: article
Study design: Observational Study
Abstract: Introduction and Objectives Primary biliary cholangitis (PBC) shows geographical variations worldwide. Data from Latin America is scarce, particularly for cross-country comparisons. This study aimed to describe clinical characteristics, treatment response, and outcomes of PBC across Latin American countries. Patients and Methods The retrospective, multicenter ALLATIN cohort analyzed 1,416 clear-cut PBC patients from the five largest contributing countries: Brazil (40%), Argentina (25.1%), Mexico (17.6%), Chile (9.9%), and Colombia (7.4%). Patients with concomitant liver diseases were excluded. Results The cohort was 93.8% female with a median age at diagnosis of 53 years. Significant cross-country heterogeneity was observed (Table 1). Antimitochondrial antibody positivity was 76.3% overall but lower in Colombia (53.3%, p<0.001). Asymptomatic presentation at diagnosis was 19.3% overall, highest in Argentina (25.5%, p=0.003). Response rates to ursodeoxycholic acid (UDCA) varied by criteria: Toronto (59%), Paris-2 (40.1%), POISE (38.7%), and deep-response (14.5%); Argentina consistently showed higher response rates (p0.008). Fibrates as second-line therapy were used in 30.2% of patients, with higher adoption in Mexico (37.1%) and lower in Colombia (8.6%, p<0.001). Finally, transplant-free survival differed significantly across countries (log-rank p<0.001), with Mexico showing a higher risk of death or liver transplantation compared to Chile (HR 4.36, 95%CI 2.1–10.9, p<0.001). Conclusions In the largest Latin American PBC cohort reported, there was significant heterogeneity in presentation, response to UDCA and long-term prognosis across countries. These findings highlight that even when selecting clear-cut PBC subjects, specific genetic, economic, social and cultural country-related factors influence disease course. Regional strategies for optimal risk stratification and management should be taken into consideration.
Source: Annals of Hepatology
Authors: Claudia Couto, Guilherme Cançado, Jhon Prieto, Graciela Castro-Narro, Maria Ferraz, Débora Terrabuio, Lorena Castro, Alejandra Villamil, Esteban Gonzalez, Cristiane Villela-Nogueira, Viridiana Guevara, Ezequiel Ridruejo, Harlim Rodriguez, Maria González-Huezo, Fernando Cairo, Jonathan Aguirre, Elze De Oliveira, Adelina Lozano, Nicolás Ortiz-López, Janaina Schiavon, Paulo Bittencourt, Fernando Bessone, Maria Anders, Roberto Perez, Manuel Mendizabal, Rodrigo Zapata, Daniela Perez, Alma Kuljacha, Mario Pessoa, Hugo Cheinquer, Liliana Mendes, Cristiane Tovo, Pablo Coste, Stefanny Cornejo-Hernández, Adriana Varon, Maria Chindamo, Daniela Simian, Raul Lazarte, Melisa Dirchwolf, Miguel Escobedo, Juan Córdoba, Ivan López-Mendez, Ana Feldner, Sarah Rufino, Luciana Faria, Franco Weisser, Andreina Fragenas, Ilse Pardo, Vivian Rotman, Carlos Coronel-Castillo, Mirta Peralta, Danay Guerrero, Luis Rosales, Manuel Barbero, Paula Chiodi, Ana Castro, Lucas Carvalho, Alvaro Urzúa, Leonardo Schiavon, Daniela Moreno, Sebastián Gil, Diana Alfonso, Diego Puentes, Nalu Navarro-Alvarez, Raimundo Gama, Fernanda Gelape, Mateus Nardelli, Bernardo Moraes, Rodrigo Sanchez, Matías Bori, Rodrigo Galván, Marlen Castellanos, Marcela Ibarra, Nicolas Dominguez, Eduardo Cançado, Nélia Hernandez
Institutions: Universidade Federal de Minas Gerais, Hospital Médica Sur, Hospital São Paulo, Universidade Federal de São Paulo, Universidade de São Paulo, Hospital das Clínicas da Faculdade de Medicina da Universidade de São Paulo, Universidad de Los Andes, Chile, Hospital Italiano de Buenos Aires, Hospital de Clínicas "José de San Martín", Universidade Federal do Rio de Janeiro, Hospital General de México, Centro de Educación Médica e Investigaciones Clínicas Norberto Quirno, Instituto de Gastroenterología, Hospital Materno Infantil Instituto de Seguridad Social del Estado de México y Municipios (ISSEMyM), Hospital El Cruce, Hospital Angeles Pedregal, Centro Universitário Lusíada, Hospital Clínico de la Universidad de Chile, Universidade Federal de Santa Catarina, Hospital Alemán, Hospital Universitario Austral, Clínica Alemana, Hospital de Clínicas de Porto Alegre, Hospital de Base, Santa Casa Hospital, Hospital Central Militar, Clinica Santa Maria, Hospital Universitario Dr José Eleuterio Gonzalez, Clínica Dávila, Hospital de Clínicas, Universidad Nacional de Colombia, Instituto Nacional de Ciencias Médicas y Nutrición Salvador Zubirán
Language: English
Topic: Liver Diseases and Immunity
Subfield: Hepatology
Field: Medicine
Domain: Health Sciences
Open Access status: gold
Estimated APC paid: $1,500
Funder: Gilead Sciences
OpenAlex ID: W7204236903