AUTHOR=Chen Youran , Yang Yanyan , Li Shanshan , Lin Minghao , Xie Xueting , Shi Huifang , Jiang Yuchun , Zheng Sijie , Shao Hui , Yang Naibin , Lu Mingqin 

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

JOURNAL=Frontiers in Public Health

VOLUME=Volume 9 - 2021

YEAR=2022

URL=https://www.frontiersin.org/journals/public-health/articles/10.3389/fpubh.2021.784718

DOI=10.3389/fpubh.2021.784718

ISSN=2296-2565

ABSTRACT=Increased protein induced by vitamin K absence or antagonist-II (PIVKA-II) levels had been widely reported in patients with 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 normal PIVKA-II group (<32mAU/L), patients in elevated PIVKA-II group (>32mAU/L) had much higher serum TBIL, DBIL, IBIL, and TBA levels (p<0.05 for each). Compared with slightly elevated PIVKA-II group (32-125 mAU/L), patients in significantly elevated PIVKA-II group (>125mAU/L) had much lower serum albumin, ALT, AST levels and longer days for hospital stay (p<0.05 for each). The association of PIVKA-II with TBIL and DBIL was an inverted U-shaped curve with an inflection point at 199.1mAU/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 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.