Are nucleos(t)ide analogues effective against severe outcomes in COVID-19 and hepatitis B virus coinfection?

• Published in: Hepatology forum 2021-09, Vol.2 (3), p.91-96
• Main Authors: Adali, Gupse, Gokcen, Pinar, Guzelbulut, Fatih, Gokcen Degirmenci Salturk, Ayca, Bugra Agaoglu, Nihat, Unal, Busra, Doganay, Levent, Ozdil, Kamil
• Format: Article
• Language: English
• Subjects: COVID-19 outcomes in HBV coinfection
• ISSN: 1307-5888; 2757-7392
• DOI: 10.14744/hf.2021.2021.0027

Background and AimThe impact of chronic hepatitis B virus (HBV) infection and nucleos(t)ide analogue (NUC) treatment on disease severity and clinical outcomes in patients with coronavirus 2019 (COVID-19) is unknown. The objective of this study was to determine whether HBV infection and the use of NUCs impacts mortality in patients with COVID-19. Materials and MethodsA total of 231 adult patients (77 with COVID-19 and HBV coinfection) with a laboratory-confirmed diagnosis of COVID-19 were enrolled in this retrospective study. Univariate and binary logistic regression analysis were performed to evaluate the risk factors for mortality from COVID-19. ResultsPatients with COVID-19 and HBV coinfection had a similar rate of mortality to those without HBV coinfection (7.8% vs 9.7%; p=0.627). Cardiovascular disease (odds ratio [OR]: 8.22, 95% confidence interval [CI]: 1.52-44.2; p=0.014) and a high basal aspartate transaminase level (OR: 7.94, 95% CI: 1.81-34.8; p=0.006) were independent predictors of mortality due to COVID-19. In the COVID-19 and HBV coinfection group, the patients who died had a significantly higher median level of HBV DNA than patients who survived (378 IU/mL vs 0 IU/mL; p=0.048). Thirty (39%) patients with HBV coinfection received NUC treatment, and none of these patients died. ConclusionHBV infection was not associated with mortality in patients with COVID-19, and it seems that NUC treatment for HBV infection might have an antiviral effect on severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection.