PIVKA-II – AN INDEPENDENT INDICATOR OF ACUTE AND ACUTE-ON-CHRONIC LIVER FAILURE

Authors

  • Beti Todorovska
  • Gregor Krstevski University Clinic for Gastroenterohepatology, Skopje, Republic of North Macedonia Faculty of Medicine, Ss. Cyril and Methodius University in Skopje, Republic of North Macedonia
  • Fana Josifovikj Lichoska University Clinic for Gastroenterohepatology, Skopje, Republic of North Macedonia Faculty of Medicine, Ss. Cyril and Methodius University in Skopje, Republic of North Macedonia
  • Elena Ristovska Curakova University Clinic for Gastroenterohepatology, Skopje, Republic of North Macedonia Faculty of Medicine, Ss. Cyril and Methodius University in Skopje, Republic of North Macedonia
  • Emilija Trpchevska Nikolovska University Clinic for Gastroenterohepatology, Skopje, Republic of North Macedonia Faculty of Medicine, Ss. Cyril and Methodius University in Skopje, Republic of North Macedonia
  • Dzem Adem University Clinic for Gastroenterohepatology, Skopje, Republic of North Macedonia Faculty of Medicine, Ss. Cyril and Methodius University in Skopje, Republic of North Macedonia
  • Kalina Stardelova Grivcheva University Clinic for Gastroenterohepatology, Skopje, Republic of North Macedonia Faculty of Medicine, Ss. Cyril and Methodius University in Skopje, Republic of North Macedonia
  • Nenad Joksimovic University Clinic for Gastroenterohepatology, Skopje, Republic of North Macedonia Faculty of Medicine, Ss. Cyril and Methodius University in Skopje, Republic of North Macedonia
  • Mitko Miloshevski University Clinic for Gastroenterohepatology, Skopje, Republic of North Macedonia Faculty of Medicine, Ss. Cyril and Methodius University in Skopje, Republic of North Macedonia
  • Vladimir Andreevski University Clinic for Gastroenterohepatology, Skopje, Republic of North Macedonia Faculty of Medicine, Ss. Cyril and Methodius University in Skopje, Republic of North Macedonia
  • Magdalena Dimitrova Genadieva University Clinic for Gastroenterohepatology, Skopje, Republic of North Macedonia Faculty of Medicine, Ss. Cyril and Methodius University in Skopje, Republic of North Macedonia
  • Filip Nikolov University Clinic for Gastroenterohepatology, Skopje, Republic of North Macedonia Faculty of Medicine, Ss. Cyril and Methodius University in Skopje, Republic of North Macedonia
  • Stefan Pejkovski University Clinic for Gastroenterohepatology, Skopje, Republic of North Macedonia Faculty of Medicine, Ss. Cyril and Methodius University in Skopje, Republic of North Macedonia
  • Dafina Nikolova University Clinic for Gastroenterohepatology, Skopje, Republic of North Macedonia Faculty of Medicine, Ss. Cyril and Methodius University in Skopje, Republic of North Macedonia
  • Ance Volkanovska University Clinic for Gastroenterohepatology, Skopje, Republic of North Macedonia Faculty of Medicine, Ss. Cyril and Methodius University in Skopje, Republic of North Macedonia
  • Gjorgji Deriban University Clinic for Gastroenterohepatology, Skopje, Republic of North Macedonia Faculty of Medicine, Ss. Cyril and Methodius University in Skopje, Republic of North Macedonia
  • Arzana Jusufi Hasani University Clinic for Gastroenterohepatology, Skopje, Republic of North Macedonia Faculty of Medicine, Ss. Cyril and Methodius University in Skopje, Republic of North Macedonia
  • Dijana Rafajlovska Bibovska University Clinic for Gastroenterohepatology, Skopje, Republic of North Macedonia Faculty of Medicine, Ss. Cyril and Methodius University in Skopje, Republic of North Macedonia
  • Ilina Todorovska Faculty of Medicine, Ss. Cyril and Methodius University in Skopje, Republic of North Macedonia
  • Vesna Stefanovska Velikj Faculty of Medicine, Ss. Cyril and Methodius University in Skopje, Republic of North Macedonia Institute of Epidemiology and Biostatistics with Medical Informatics, Skopje, Republic of North Macedonia
  • Meri Trajkovska University Clinic for Gastroenterohepatology, Skopje, Republic of North Macedonia Faculty of Medicine, Ss. Cyril and Methodius University in Skopje, Republic of North Macedonia

DOI:

https://doi.org/10.53582/0vavmj12

Keywords:

PIVKA-II, Hepatocellular Carcinoma, Liver failure, Screening

Abstract

Introduction: PIVKA-II is an abnormal coagulation factor induced by vitamin K absence or use of vitamin K antagonists, and is useful in the diagnosis of hepatocellular carcinoma (HCC). PIVKA-II may also correlate with liver failure, with one study demonstrating an association with hepatitis E infection.

Materials and methods: A total of 406 subjects with chronic viral hepatitis, steatofibrosis, cirrhosis and hepatocellular carcinoma were evaluated for PIVKA-II, AFP, BCLC (only HCC patients), Child-Pugh-Tourcotte score, and MELD-Na score.

Results: A statistically significant positive correlation was found between PIVKA-II and MELD-Na and CPT scores.

Conclusion: PIVKA-II may be an independent indicator of acute and acute-on-chronic liver failure.

References

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Published

2026-06-18

Issue

Vol. 6 No. 2 (2026): Acad Med J

Section

Original Articles

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Copyright (c) 2026 Beti Todorovska, Gregor Krstevski, Fana Josifovikj Lichoska, Elena Ristovska Curakova, Emilija Trpchevska Nikolovska, Dzem Adem, Kalina Stardelova Grivcheva, Nenad Joksimovic, Mitko Miloshevski, Vladimir Andreevski, Magdalena Dimitrova Genadieva, Filip Nikolov, Stefan Pejkovski, Dafina Nikolova, Ance Volkanovska, Gjorgji Deriban, Arzana Jusufi Hasani, Dijana Rafajlovska Bibovska, Ilina Todorovska, Vesna Stefanovska Velikj, Meri Trajkovska

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