The serologic hallmark of primary biliary cirrhosis (PBC) is the presence of high titer, and specific anti-mitochondrial antibodies (AMA). Interestingly, although there is no global immune defect in patients with PBC, there is widespread dysregulated B cell function, including increased sera levels of IgM and enhanced B cell responses to CpG stimulation. The mechanisms involved in this B cell dysfunction have remained unknown. To address this issue, we focused on identifying the frequencies of B cell subsets in patients with PBC and the mechanisms that lead to B cell dysregulation, including the relationships with CXCR5+CD4+T cells. Herein we report that elevations of both serum and intrahepatic IL-21 were found in patients with PBC and, in particular, promoted B cell proliferation, STAT3 phosphorylation and AMA production in vitro. More importantly, upon stimulation with rPDC-E2, CXCR5+CD4+T cells in PBC produced higher levels of IL-21 than healthy controls. Additionally, sorted CXCR5+CD4+T cells increased production of AMA by autologous CD19+B cells. Indeed, elevated expression of intrahepatic CXCL13, a key chemokine of CXCR5+ cells, was uniquely found within the portal tracts in PBC, accompanied by infiltrates of CD4+, CXCR5+, CD19+, and CD38+ cells. In conclusion, CXCL13 promotes aggregation of CD19+B cells and CXCR5+CD4+T cells, which directs the aberrant AMA response via IL-21. These data have implications for potential immunotherapy and also reflect the unique lymphoid biology in the liver of PBC.