Changes and Clinical Significance of PIVKA-II in Hepatitis E Patients

• Published in: Frontiers in public health 2022-01, Vol.9, p.784718-784718
• Main Authors: Chen, Youran, Yang, Yanyan, Li, Shanshan, Lin, Minghao, Xie, Xueting, Shi, Huifang, Jiang, Yuchun, Zheng, Sijie, Shao, Hui, Yang, Naibin, Lu, Mingqin
• Format: Article
• Language: English
• Subjects: acute hepatitis; alpha-Fetoproteins - metabolism; Bilirubin; Biomarkers; Carcinoma, Hepatocellular - pathology; Hepatitis E; Humans; liver function; liver insufficiency; Liver Neoplasms - pathology; PIVKA-II; Protein Precursors; Prothrombin; Public Health
• ISSN: 2296-2565; 2296-2565
• DOI: 10.3389/fpubh.2021.784718

Increased protein induced by vitamin K absence or antagonist-II (PIVKA-II) levels had been widely reported in patients with hepatocellular carcinoma (HCC) and chronic hepatitis. However, the role of PIVKA-II in hepatitis E is unclear. The aim of this study was to clarify the changes related with PIVKA-II and its clinical significance in hepatitis E. We enrolled 84 patients with hepatitis E hospitalized in two hospitals from December 2019 to June 2021. The levels of serum PIVKA-II and related serological indicators in the patients were determined to elucidate the role of PIVKA-II in hepatitis E. We observed that 59.51% (50/84) of patients showed an increase in PIVKA-II levels. Compared with the normal PIVKA-II group (32 mAU/L) had much higher serum total bilirubin (TBIL), direct bilirubin (DBIL), indirect bilirubin (IBIL), and total bile acid (TBA) levels ( < 0.05 for each). Compared with the slightly elevated PIVKA-II group (32-125 mAU/L), patients in the significantly elevated PIVKA-II group (>125 mAU/L) had much lower serum albumin, alanine aminotransferase (ALT), aspartate transaminase (AST) levels, and longer days for the hospital stay ( < 0.05 for each). The association of PIVKA-II with TBIL and DBIL was an inverted U-shaped curve with an inflection point at 199.1 mAU/L). The association of PIVKA-II with IBIL was a U-shaped curve with an inflection point at 18.6 mAU/L while the association of PIVKA-II with albumin was an inverted U-shaped curve with an inflection point at 18.6 mAU/L. With the improvement of the disease, PIVKA-II levels were gradually decreased and finally returned to normal. This trend was consistent with that of bilirubin, and a peak appeared in the third week. Therefore, findings from our study show that the increase in PIVKA-II levels can be related to the degree of hepatic insufficiency in patients with hepatitis E, wherein PIVKA-II levels are transiently increased, and the trend of change can be related to the disease course.