Tenofovir reduces COVID-19 severity among patients with chronic hepatitis B

Tenofovir reduced the severity of COVID-19 infection among patients with chronic hepatitis B, according to a presentation at the International Liver Congress.

“In the first half of 2020, I saw that HIV patients treated with antiretroviral regimes, including tenofovir, presented with less incidence and also less severity of COVID-19,” Beatriz Mateos Munoz, PhD, Hospital Universitario Ramón y Cajal, University of Alcala, Madrid, Spain, said. “The aim of our study was to analyze the severity and the incidence of COVID-19 on chronic HBV patients on treatment with tenofovir or entecavir and also to do a comparison between both therapies”

In a database search, researchers identified 4,736 adult patients with HBV; of these, 117 patients had both HBV and COVID-19 (2.5%; 95% CI, 2.1-2.9) with 67 patients treated with tenofovir and 50 patients treated with entecavir. Study data showed that patients with HBV and COVID-19, 35% were hospitalized, 4.3% were admitted to ICU and 5.1% died.

According to study results, patients treated with entecavir had greater rates of obesity (22% vs. 9%), diabetes (32% vs. 12%), ischemic cardiopathy (14% vs. 3%) and arterial hypertension (44% vs. 18%) as well as a trend for greater severity of advanced fibrosis compared with patients treated with tenofovir. Further, while COVID-19 incidence was similar in both treatment groups (0.023 vs. 0.026), patients treated with entecavir more often had severe COVID-19 (36% vs. 6%) and required subsequent health care use such as ICU admission (10% vs. 0%) and ventilatory support (10% vs. 2%), which led to a higher rate of death (10% vs. 1%). Multivariate logistic regression yielded a sixfold reduction in the risk for severe COVID-19 among patients treated with tenofovir (OR = 0.17; 95% CI, 0.04-0.67).

“Our results conclude that tenofovir seems to share a protective effect from severe COVID-19 in patients with chronic HBV,” Munoz concluded.