Association Between Chronic Hepatitis B and SARS-CoV-2 Infection

Both Hepatitis B virus (HBV) and SARS-CoV-2 can cause liver damage and hence it is important to understand the impact of HBV on SARS-CoV-2 infected patients. A large-scale, population-based, nationwide cohort study was conducted to measure the potential associations between CHB and the use of antiviral therapy with SARS-CoV-2 infection rates.

A total of 204,418 patients were included with 7,723 SARS-CoV-2 test positive patients (case-patients) and 46,231 with negative SARS-CoV-2 test as random control. Primary endpoints were SARS-CoV-2 infection and severe clinical outcomes of COVID-19.

The prevalence of CHB was lower in COVID-19 positive patients (3.5%) than the control group (5.4%). Also, the proportion of patients with CHB taking antiviral drugs was 0.6% in case patients and 1.3% in controls. Thus, underlying CHB and its antiviral agent medication were significantly associated with a lower SARS-CoV-2 positivity rate. A further subanalysis of antiviral agents showed that tenofovir and entecavir were associated with a reduced SARS-CoV-2 positivity rate. Moreover, 5.4% of patients suffered from severe COVID-19 and 5.1% of fatalities occurred in patients with CHB. Additionally, among 50 patients with antiviral therapy, severe COVID-19 occurred in 8% of patients with a 4% fatality rate. Also, among 37% of patients with CHB-associated with cirrhosis, 26.9% had severe COVID-19 and 25% died.

Thus, the study concluded that SARS-COV-2 infection is lower in CHB patients and the antiviral treatment including tenofovir reduced the risk of COVID-19. Further investigation using randomized controlled studies are needed to evaluate the effects of antiviral drugs including tenofovir for the treatment and prevention of COVID-19.

Source: PLos One



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