COVID-19 and hepatitis B infection

Area of Science:

• Hepatology and Infectious Diseases
• Virology and Public Health

Background:

• The COVID-19 pandemic presents significant global health challenges, impacting liver function in infected individuals.
• Hepatitis B Virus (HBV) infection chronically affects a large global population, necessitating integrated management strategies.
• Co-infection or underlying HBV in COVID-19 patients raises complex clinical management questions.

Purpose of the Study:

• To review and highlight the challenges in managing patients with chronic HBV infection in the context of the COVID-19 pandemic.
• To emphasize the need for cautious use of certain COVID-19 treatments in HBV-infected patients.
• To underscore the importance of HBV screening and monitoring in at-risk populations during the pandemic.

Main Methods:

• Review of existing literature on COVID-19, liver involvement, and HBV infection management.
• Analysis of reported cases and studies concerning drug-induced liver injury and viral reactivation.
• Synthesis of current recommendations and identification of knowledge gaps.

Main Results:

• COVID-19 patients exhibit varying degrees of liver injury, indicated by elevated liver enzymes, especially in severe cases.
• Certain treatments for COVID-19, such as tocilizumab and corticosteroids, have been associated with HBV reactivation.
• Limited data exists on the comprehensive management of COVID-19 patients with pre-existing chronic liver disease, including HBV.

Conclusions:

• Careful monitoring and HBV screening are crucial for COVID-19 patients, particularly those with elevated liver enzymes or from high-prevalence areas.
• Hepatitis B Virus (HBV) screening and prophylaxis are recommended before initiating certain immunosuppressive therapies for COVID-19.
• Further research is essential to establish evidence-based guidelines for managing COVID-19 patients with chronic HBV infection and prevent liver decompensation.