COVID-19 or treatment associated immunosuppression may trigger hepatitis B virus reactivation: A case report

Wu, Yifeng; Yu, Wanjun; Jiang, Yuhua; Yin, Chen; Zhang, Bo; Zhen, Rui-Bing; Zhang, Juntao; Wang, Yiping; Li, Qiang; Xu, Feng; Shi, Yifeng; Li, Xian-Peng

doi:10.12998/wjcc.v9.i19.5266

Cited by 14 publications

(13 citation statements)

References 4 publications

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“…Sudden rise in the level of HBV DNA in the subsequent testing [ 35 , 46 , 50 , 58 , 83 ]or seropositive for HB surface antigen, HB core antigen IgM, HB envelope antibody (not specified) [ 36 ]…”

Section: Resultsmentioning

confidence: 99%

Viral reactivations and co-infections in COVID-19 patients: a systematic review

et al. 2023

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Background Viral reactivations and co-infections have been reported among COVID-19 patients. However, studies on the clinical outcomes of different viral reactivations and co-infections are currently in limit. Thus, the primary purpose of this review is to perform an overarching investigation on the cases of latent virus reactivation and co-infection in COVID-19 patients to build collective evidence contributing to improving patient health. The aim of the study was to conduct a literature review to compare the patient characteristics and outcomes of reactivations and co-infections of different viruses. Methods Our population of interest included confirmed COVID-19 patients who were diagnosed with a viral infection either concurrently or following their COVID-19 diagnosis. We extracted the relevant literature through a systematic search using the key terms in the online databases including the EMBASE, MEDLINE, Latin American Caribbean Health Sciences Literature (LILACS), from inception onwards up to June 2022. The authors independently extracted data from eligible studies and assessed the risk of bias using the Consensus-based Clinical Case Reporting (CARE) guidelines and the Newcastle–Ottawa Scale (NOS). Main patient characteristics, frequency of each manifestation, and diagnostic criteria used in studies were summarized in tables. Results In total, 53 articles were included in this review. We identified 40 reactivation studies, 8 coinfection studies, and 5 studies where concomitant infection in COVID-19 patients was not distinguished as either reactivation or coinfection. Data were extracted for 12 viruses including IAV, IBV, EBV, CMV, VZV, HHV-1, HHV-2, HHV-6, HHV-7, HHV-8, HBV, and Parvovirus B19. EBV, HHV-1, and CMV were most frequently observed within the reactivation cohort, whereas IAV and EBV within the coinfection cohort. In both reactivation and coinfection groups, patients reported cardiovascular disease, diabetes, and immunosuppression as comorbidities, acute kidney injury as complication, and lymphopenia and elevated D-dimer and CRP levels from blood tests. Common pharmaceutical interventions in two groups included steroids and antivirals. Conclusion Overall, these findings expand our knowledge on the characteristics of COVID-19 patients with viral reactivations and co-infections. Our experience with current review indicates a need for further investigations on virus reactivation and coinfection among COVID-19 patients.

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Section: Resultsmentioning

confidence: 99%

Viral reactivations and co-infections in COVID-19 patients: a systematic review

et al. 2023

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“…Wu et al [ 26 ] evaluated a 45-year-old male with chronic HBV infection for over 20 years, initially treated with adefovir dipivoxil and ETV and subsequently with ETV alone [ 26 ].…”

Section: Clinical Data From the Literaturementioning

confidence: 99%

“…TDF was added to ETV therapy, the flare abated, and the patient recovered from COVID-19. The clinical course of the illness does not allow discrimination between COVID-19 and steroid administration as a possible cause of HBV reactivation [ 26 ].…”

Section: Clinical Data From the Literaturementioning

confidence: 99%

COVID-19 as Another Trigger for HBV Reactivation: Clinical Case and Review of Literature

Sagnelli

Montella²,

Grimaldi³

et al. 2022

Pathogens

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Universal hepatitis B virus (HBV) vaccination has been applied for years in most countries, but HBV infection remains an unresolved public health problem worldwide, with over one-third of the world’s population infected during their lifetime and approximately 248 million hepatitis B surface antigen (HBsAg) chronic carriers. HBV infection may reactivate with symptomatic and sometimes life-threatening clinical manifestations due to a reduction in the immune response of various origins, due to chemotherapy or immunosuppressive therapy, treatments increasingly practiced worldwide. SARS-CoV-2 and its COVID-19 associated disease have introduced new chances for HBV reactivation due to the use of dexamethasone and tocilizumab to counteract the cytokine storm. This could and should be prevented by accurate screening of HBV serologic markers and adequate pharmacologic prophylaxis. This article describes the case of a patient with COVID-19 who developed HBV reactivation and died of liver failure and analyzes published data on this setting to provide useful information to physicians who manage these patients during the SARS-CoV-2 pandemic.

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“…TDF was added to therapy and HBV reactivation rapidly resolved. The nasopharyngeal molecular swab to detect SARS-CoV-2 RNA became permanently negative and the patient recovered from COVID-19 [ 123 ].…”

Section: Hbv Reactivation In Patients With Covid-19mentioning

confidence: 99%

Prevention of HBV Reactivation in Hemato-Oncologic Setting during COVID-19

et al. 2022

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Onco-hematologic patients are highly susceptible to SARS-CoV-2 infection and, once infected, frequently develop COVID-19 due to the immunosuppression caused by tumor growth, chemotherapy and immunosuppressive therapy. In addition, COVID-19 has also been recognized as a further cause of HBV reactivation, since its treatment includes the administration of corticosteroids and some immunosuppressive drugs. Consequently, onco-hematologic patients should undergo SARS-CoV-2 vaccination and comply with the rules imposed by lockdowns or other forms of social distancing. Furthermore, onco-hematologic facilities should be adapted to new needs and provided with numerically adequate health personnel vaccinated against SARS-CoV-2 infection. Onco-hematologic patients, both HBsAg-positive and HBsAg-negative/HBcAb-positive, may develop HBV reactivation, made possible by the support of the covalently closed circular DNA (cccDNA) persisting in the hepatocytic nuclei of patients with an ongoing or past HBV infection. This occurrence must be prevented by administering high genetic barrier HBV nucleo(t)side analogues before and throughout the antineoplastic treatment, and then during a long-term post-treatment follow up. The prevention of HBV reactivation during the SARS-CoV-2 pandemic is the topic of this narrative review.

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COVID-19 or treatment associated immunosuppression may trigger hepatitis B virus reactivation: A case report

Cited by 14 publications

References 4 publications

Viral reactivations and co-infections in COVID-19 patients: a systematic review

Viral reactivations and co-infections in COVID-19 patients: a systematic review

COVID-19 as Another Trigger for HBV Reactivation: Clinical Case and Review of Literature

Prevention of HBV Reactivation in Hemato-Oncologic Setting during COVID-19

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