How Does Chronic Hepatitis B Infection Impact on Severity of COVID-19 Infection?

Abstract

Background: Studies on COVID-19 infection in patients with hepatitis B have yielded conflicting results. Objectives: Key areas of focus include the impact of chronic hepatitis B (CHB) on the immune system, its interaction with other viruses, and the effectiveness of antiviral treatment in these patients. Methods: This cross-sectional study examined patients with CHB and healthy individuals diagnosed with COVID-19. The study involved 300 patients referred to the infectious disease clinic on an outpatient basis. The cohort comprised 150 patients with CHB infection [50 carriers and 100 treated with tenofovir (TDF)], and 150 healthy COVID-19-infected patients without a history of underlying disease. Results: The study included 178 female patients (59.4%) and 122 male patients (40.6%). The statistical significance of COVID-19 infection differed between female and male patients in the CHB group (P-value = 0.03). Patients in the control group experienced more severe symptoms and higher hospitalization rates (both P-value < 0.001). For CHB patients, the relationship between TDF use and hospitalization or infection severity was not statistically significant. All patients in the hepatitis group survived, whereas two patients died in the control group. Conclusions: The presence of hepatitis infection appears to mitigate the severity of COVID-19, resulting in fewer hospitalizations and ICU admissions. Chronic hepatitis B may influence the characteristics, transmission, and function of COVID-19 in affected individuals due to its impact on the immune system, its interactions with other viruses, and the effects of antiviral therapy.