Mihai, N.; Olariu, M. C.; Ganea, O.-A.; Adamescu, A.-I.; Molagic, V.; Aramă, Ș. S.; Tilișcan, C.; Aramă, V. Risk of Hepatitis B Virus Reactivation in COVID-19 Patients Receiving Immunosuppressive Treatment – Prospective Study. Preprints2024, 2024091173. https://doi.org/10.20944/preprints202409.1173.v1
APA Style
Mihai, N., Olariu, M. C., Ganea, O. A., Adamescu, A. I., Molagic, V., Aramă, Ș. S., Tilișcan, C., & Aramă, V. (2024). Risk of Hepatitis B Virus Reactivation in COVID-19 Patients Receiving Immunosuppressive Treatment – Prospective Study. Preprints. https://doi.org/10.20944/preprints202409.1173.v1
Chicago/Turabian Style
Mihai, N., Cătălin Tilișcan and Victoria Aramă. 2024 "Risk of Hepatitis B Virus Reactivation in COVID-19 Patients Receiving Immunosuppressive Treatment – Prospective Study" Preprints. https://doi.org/10.20944/preprints202409.1173.v1
Abstract
Objectives: This study aimed to evaluate the risk of hepatitis B virus reactivation (HBVr) in COVID-19 patients receiving immunosuppressive treatment, which has been insufficiently studied to date. Secondarily, we aimed to evaluate the seroprevalence of HBV infection in COVID-19 patients. Methods: We performed an HBV screening in all Romanian adults hospitalized in 4 COVID-19 wards between October 2021 and September 2022. We enrolled patients with positive hepatitis B core antibody (anti-HBc) without protective hepatitis B surface antibody (anti-HBs), HBV treatment or immunosuppressive conditions, whom we followed virologically at 3 months. Results: We identified 333/835 (39.9%) anti-HBc-positive patients. Follow-up was performed in 13 patients with positive hepatitis B surface antigen (HbsAg) and 19 HBsAg-negative/anti-HBc-positive patients. Among those who received immunosuppressants, 4/23 (17.4%) patients experienced HBVr: 1 out of 8 (12.5%) HBsAg-positive patients (with 1.99 log increase in HBV DNA level) and 3 out of 15 (20%) HBsAg-negative/anti-HBc-positive patients (with de novo detectable HBV DNA level). Conclusions: Administration of COVID-19 immunosuppressants may result in a significant risk of HBVr in co-infected patients. We recommend performing an HBV triple screen panel (HBsAg, anti-HBs, anti-HBc) in all COVID-19 patients receiving immunosuppressive treatment. HBV prophylaxis may be indicated in certain patients. Larger studies are needed in order to establish an appropriate and cost-effective management in these patients.
Keywords
SARS-CoV-2; COVID-19; immunosuppressive agents; hepatitis B virus; reactivation
Subject
Medicine and Pharmacology, Epidemiology and Infectious Diseases
Copyright:
This is an open access article distributed under the Creative Commons Attribution License which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.
