Fatigue was worse in patients with cirrhosis in our study, which failed to agree with the majority of studies displaying fatigue and HRQoL in general to be independent of disease severity.[2,3,20] In line with this, presence of PBC-specific ANA, namely anti-sp100 and anti-gp210, known to characterize patients with unfavorable disease outcome, including more severe histological stage, were associated with worse fatigue and cognitive function in our population.[11,14] However, contrary to our findings, fatigue was not associated with cirrhosis in the Polish PBC population.[20]. This evidence concerns the gene SP100 and primary biliary cholangitis.