 Eligible participants will include those patients with a diagnosis of PBC with overlap features of AIH and in whom liver enzymes have not sufficiently improved with ursodiol therapy the alkaline phosphatase is not less than twice upper normal. At entry all patients will have a history and physical examination, blood tests, bone densitometry and complete quality of life questionnaires. Patients will be prescribed Budesonide 9 mg to take daily for one year in addition to the ursodiol. The medication can be taken with or without food. Blood tests and symptoms diaries will be completed every 3 months. Patients will be contacted by phone to assess tolerance of the medication and any new health problems. At one year, patients will return for a history and physical and repeat blood tests and bone densitometry. Possible side-effects include bone mass loss bone thinning, diarrhea, indigestion, nausea, joint pains, dizziness, headaches, weight gain and Cushings syndrome. Other side-effects are possible. The medication and the tests will be billed to the patient or patients insurance. 