Clinical Characteristics and Outcomes in Patients with Chronic HBV Infection and Hospitalized for COVID-19 Pneumonia: A Retrospective Cohort Study.

IF 3.8 3区医学 Q2 VIROLOGY Viruses-Basel Pub Date : 2024-12-30 DOI:10.3390/v17010040

Lucio Boglione, Maria Grazia Crobu, Mario Pirisi, Carlo Smirne

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Abstract

The effects of a concomitant infection of hepatitis B virus (HBV) and severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) are still debated, with a recognized major risk of HBV reactivation during immune-suppressive treatments. The aim of this study was to determine the prevalence and predictive factors of HBV reactivation in a cohort of hospitalized patients with coronavirus disease 2019 (COVID-19) and a current or past hepatitis B infection. In a monocentric retrospective observational study, we enrolled all consecutive hospital admitted patients with COVID-19 pneumonia and a positive HBV serology (N = 84) in our Infectious Diseases Unit from April 2021 to December 2023. We identified 18 (21%) HBsAg-positive/anti-HBc-positive, 41 (49%) HBsAg-negative/anti-HBc-positive/anti-HBs-positive, and 25 (30%) HBsAg-negative/anti-HBc-positive/anti-HBs-negative subjects. The overall rate of hepatitis flare was 10.7%, without any HBsAg seroreversion, severe HBV reactivation, and/or need for new HBV antiviral therapy introduction. Systemic corticosteroid treatment for COVID-19 and baseline anti-HBsAg status were associated with this risk of HBV reactivation. In conclusion, the overall risk of hepatitis flares in hospitalized COVID-19 was reasonably low, with higher doses of corticosteroids treatment being the major risk factor for HBV reactivation, and anti-HBs-positive serological status as a protective element.

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乙型肝炎病毒（HBV）和严重急性呼吸系统综合征冠状病毒 2（SARS-CoV-2）同时感染的影响仍存在争议，而在免疫抑制治疗期间，HBV 再激活的主要风险已得到公认。本研究旨在确定2019年冠状病毒病（COVID-19）住院患者队列中HBV再激活的流行率和预测因素，以及当前或过去的乙型肝炎感染情况。在一项单中心回顾性观察研究中，我们招募了 2021 年 4 月至 2023 年 12 月期间感染性疾病科所有连续住院的 COVID-19 肺炎和 HBV 血清学阳性患者（N = 84）。我们发现了18例（21%）HBsAg阳性/抗-HBc阳性、41例（49%）HBsAg阴性/抗-HBc阳性/抗-HBs阳性和25例（30%）HBsAg阴性/抗-HBc阳性/抗-HBs阴性受试者。肝炎复发的总体比例为 10.7%，没有出现任何 HBsAg 血清学转换、严重的 HBV 再激活和/或需要引入新的 HBV 抗病毒疗法。COVID-19 的全身皮质类固醇治疗和基线抗 HBsAg 状态与这种 HBV 再激活风险有关。总之，住院的COVID-19患者肝炎复发的总体风险相当低，其中较高剂量的皮质类固醇治疗是HBV再激活的主要风险因素，而抗-HBs阳性血清学状态则是一个保护因素。

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来源期刊

Viruses-Basel VIROLOGY-

CiteScore

7.30

自引率

12.80%

发文量

2445

审稿时长

1 months

期刊介绍： Viruses (ISSN 1999-4915) is an open access journal which provides an advanced forum for studies of viruses. It publishes reviews, regular research papers, communications, conference reports and short notes. Our aim is to encourage scientists to publish their experimental and theoretical results in as much detail as possible. There is no restriction on the length of the papers. The full experimental details must be provided so that the results can be reproduced. We also encourage the publication of timely reviews and commentaries on topics of interest to the virology community and feature highlights from the virology literature in the ''News and Views'' section. Electronic files or software regarding the full details of the calculation and experimental procedure, if unable to be published in a normal way, can be deposited as supplementary material.