Hepatitis B does not link to increased risk for liver injury, death in COVID-19
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Chronic hepatitis B virus, whether current or past, was not associated with increased incidence of acute liver injury or death among patients with COVID-19, according to research presented at the International Liver Congress.
“There is emerging evidence that demonstrates the impact of HBV infection on COVID-19 patients. A recently published report described 105 COVID-19 patients, who also suffered from chronic HBV, showed elevated alanine aminotransferase and aspartate aminotransferase occurred in 21% and 28% of the patients, respectively,” Terry Cheuk-Fung Yip, PhD, The Chinese University of Hong Kong, said. “However, the impact of HBV infection on COVID-19 remains unclear as non-chronic HBV patients were not included as control in the previous studies. Also, the impact of past exposure to HBV remains unknown.”
In a retrospective study, researchers analyzed 5,693 patients with COVID-19 (mean age, 51 years; 49% men) from a territory-wide database to compare the incidence of liver injury and mortality among patients with a current HBV diagnosis (n = 353), a past HBV diagnosis (n = 359) or no HBV diagnosis (n = 4,927). After a median follow-up of 14 days, 2.4% of patients died and acute liver injury occurred in 1.2% of patients without HBV, 2.3% of patients with current HBV and 3.1% of patients with past HBV. Acute liver injury (adjusted HR = 2.45; 95% CI, 1.52-3.96) correlated with death while current HBV infection (aHR = 1.29; 95% CI, 0.61-2.7) and past HBV infection (aHR = 0.9; 95% CI, 0.56-1.46) did not. Similarly, corticosteroid, antifungal, ribavirin and lopinavir/ritonavir use (adjusted OR = 2.55-5.63) correlated with acute liver injury while current HBV infection (aOR = 1.93; 95% CI, 0.88-4.24) and past HBV infection (aOR = 1.25; 95% CI, 0.62-2.55) did not.
“Current or past HBV infection were not associated with death and acute liver injury,” Yip concluded. “The non-association remained robust after multivariable adjustment and propensity-score weighing.”