Peg-IFNα reduces clinical severity but cannot prevent COVID-19 infection in chronic hepatitis B patients: a cohort...

SARS-CoV-2/HBV coinfections are increasingly common as SARS-CoV-2 continues to evolve. The interferon (IFN) therapy for HBV infection might also have antiviral effects against SARS-CoV-2. To understand the effects of IFN on SARS-CoV-2 infection, we compared the clinical characteristics between IFN-treated chronic hepatitis B (CHB) patients and nucleo(s)tide analogs (NAs)-treated CHB patients during their SARS-CoV-2 infection.

Our cohort study enrolled patients with primary SARS-CoV-2 infections among IFN-treated and NAs-treated CHB patients during the Omicron wave in Shanghai, China, from December 7 2022 to January 23 2023. Clinical characteristics and self-reported acute symptoms during SARS-CoV-2 infection were collected by telephone questionnaire in January 2023.

The four most common symptoms were fever, fatigue, cough and sore throat among all enrolled participants, regardless of their treatment. Interestingly, Pegylated interferon-alpha (Peg-IFNα) treated CHB patients had a significantly higher proportion of asymptomatic infection than NAs-treated CHB patients (14.53% vs. 2.70%, p = 0.002). Additionally, IFN-treated CHB patients had significantly lower duration of fever (p = 0.018), less usage of antipyretics (p < 0.0001), less occurrence of muscle and/or joint pain (p < 0.0001), less occurrence of headache (p < 0.0001) and less occurrence of runny nose (p < 0.0001) compared to NAs-treated CHB patients.

In this real-world cohort of CHB patients infected with SARS-CoV-2 during the Omicron wave, Peg-IFNα treatment was associated with milder self-reported acute clinical manifestations, including a higher proportion of asymptomatic infection and reduced occurrence of several common symptoms.