慢性乙型肝炎感染与 COVID-19 结果之间的关联：韩国全国队列

StephenW

慢性乙型肝炎感染与 COVID-19 结果之间的关联：韩国全国队列研究
Seong Hee Kang 1 2 , Dong-Hyuk Cho 3 , Jimi Choi 4 , Soon Koo Baik 1 2 , Jun Gyo Gwon 5 , Moon Young Kim 1 2
隶属关系
隶属关系

    1
    韩国原州市延世大学原州医学院内科。
    2
    韩国原州市延世大学原州医学院再生医学研究中心。
    3
    韩国江原道原州市延世大学原州医学院内科心脏病科。
    4
    大韩民国首尔高丽大学医学院内科内分泌与代谢科。
    5
    韩国首尔高丽大学医学院移植和血管外科系。

    PMID：34610052 DOI：10.1371/journal.pone.0258229

抽象的

背景/目的：我们测量了接受严重急性呼吸综合征冠状病毒 2 (SARS-CoV-2) 检测的患者的潜在慢性乙型肝炎 (CHB) 和抗病毒药物使用与感染率之间的关联。

方法：总共包括 204,418 名在 2020 年 1 月至 6 月期间接受 SARS-CoV-2 检测的患者。对于每个 SARS-CoV-2 检测呈阳性的病例患者 (n = 7,723)，从目标人群中随机选择对照 (n = 46,231)，这些人群曾接触过 2019 年冠状病毒病 (COVID-19) 但SARS-CoV-2 检测结果呈阴性。我们从收集的韩国国民健康保险服务数据库中合并了基于索赔的数据。主要终点是 SARS-CoV-2 感染和 COVID-19 的严重临床结果。

结果：COVID-19 阳性患者（n = 267，3.5%）的潜在 CHB 比例低于 COVID-19 阴性对照（n = 2482，5.4%）。在调整合并症后，潜在的 CHB 与较低的 SARS-CoV-2 阳性率相关（调整后的优势比 [aOR] 0.65；95% 置信区间 [CI]，0.57-0.74）。在确诊为 COVID-19 的患者中，潜在的 CHB 往往使 COVID-19 严重临床结果的风险增加 66%，尽管该值在统计上不显着。包括替诺福韦和恩替卡韦在内的抗病毒治疗与 SARS-CoV-2 阳性率降低相关（aOR 0.49；95% CI，0.37-0.66），而治疗与 COVID-19 的严重临床结果无关。

结论：潜在的 CHB 和包括替诺福韦在内的抗病毒药物降低了对 SARS-CoV-2 感染的易感性。在 COVID-19 中，HBV 合并感染不会增加疾病严重程度的风险或导致更差的预后。
利益冲突声明

作者声明不存在竞争利益。

StephenW

Association between chronic hepatitis B infection and COVID-19 outcomes: A Korean nationwide cohort study
Seong Hee Kang  1   2 , Dong-Hyuk Cho  3 , Jimi Choi  4 , Soon Koo Baik  1   2 , Jun Gyo Gwon  5 , Moon Young Kim  1   2
Affiliations
Affiliations

    1
    Department of Internal Medicine, Yonsei University Wonju College of Medicine, Wonju, Republic of Korea.
    2
    Regenerative Medicine Research Center, Yonsei University Wonju College of Medicine, Wonju, Republic of Korea.
    3
    Division of Cardiology, Department of Internal Medicine, Yonsei University Wonju College of Medicine, Wonju, Gangwon, Republic of Korea.
    4
    Division of Endocrinology and Metabolism, Department of Internal Medicine, Korea University College of Medicine, Seoul, Republic of Korea.
    5
    Department of Transplantation and Vascular Surgery, Korea University College of Medicine, Seoul, Republic of Korea.

    PMID: 34610052 DOI: 10.1371/journal.pone.0258229

Abstract

Background/aims: We measured the association between underlying chronic hepatitis B (CHB) and antiviral use with infection rates among patients who underwent severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) testing.

Methods: In total, 204,418 patients who were tested for SARS-CoV-2 between January and June 2020 were included. For each case patient (n = 7,723) with a positive SARS-CoV-2 test, random controls (n = 46,231) were selected from the target population who had been exposed to someone with coronavirus disease 2019 (COVID-19) but had a negative SARS-CoV-2 test result. We merged claim-based data from the Korean National Health Insurance Service database collected. Primary endpoints were SARS-CoV-2 infection and severe clinical outcomes of COVID-19.

Results: The proportion of underlying CHB was lower in COVID-19 positive patients (n = 267, 3.5%) than in COVID-19 negative controls (n = 2482, 5.4%). Underlying CHB was associated with a lower SARS-CoV-2 positivity rate, after adjusting for comorbidities (adjusted odds ratio [aOR] 0.65; 95% confidence interval [CI], 0.57-0.74). Among patients with confirmed COVID-19, underlying CHB tended to confer a 66% greater risk of severe clinical outcomes of COVID-19, although this value was statistically insignificant. Antiviral treatment including tenofovir and entecavir was associated with a reduced SARS-CoV-2 positivity rate (aOR 0.49; 95% CI, 0.37-0.66), while treatment was not associated with severe clinical outcomes of COVID-19.

Conclusions: Underlying CHB and antiviral agents including tenofovir decreased susceptibility to SARS-CoV-2 infection. HBV coinfection did not increase the risk of disease severity or lead to a worse prognosis in COVID-19.
Conflict of interest statement

The authors have declared that no competing interests exist.