Tenofovir Disoproxil Fumarate Reduces the Severity of COVID-19 in Patients with Chronic Hepatitis B

Mateos-Muñoz, Beatriz; Buti, María; Vázquez, Inmaculada Fernández; Conde, Marta Hernández; Bernal-Monterde, Vanesa; Díaz‐Fontenla, Fernando; Morillas, Rosa María; Garcı́a-Buey, Luisa; Badía, Ester; Miquel, Mireia; Amador-Navarrete, Alberto; Rodríguez‐Tajes, Sergio; Ramos-Merino, Lucía; Madejón, Antonio; García–Retortillo, Montserrat; Arenas, Juan; Cabezas, Joaquín; Santiago, Jesús Manuel González; Fernández-Rodrı́guez, Conrado; Cordero, P.; Diago, M.; Mancebo, Antonio; Pardo, A.; Rodrı́guez, Manuel; Hoyas, E.; Moreno, Jose Javier; Turnés, Juan; Simón, Miguel Ángel; Marcos‐Fosch, Cristina; Calleja, José Luís; Bañares, Rafael; Lens, Sabela; García‐Samaniego, J.; Crespo, Javier; Romero–Gómez, Manuel; Gea, Francisco; Santiago, Enrique Rodríguez de; Moreno, Santiago; Albillos, Agustı́n

doi:10.1007/s10620-022-07817-w

Cited by 9 publications

(12 citation statements)

References 21 publications

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“…Independent of these general risk factors, having a low current CD4 + cell count, and to a lesser extent uncontrolled HIV replication and a prior AIDS diagnosis were also identified as risk factors. We did not observe an apparent protective effect of the concomitant use of tenofovir disoproxil, integrase inhibitors, nor of any other commonly used antiretroviral agent, as has been reported by other cohorts [20,21,30–33]. Other Western COVID-19 cohorts of PWH found similar patterns of risk factors for severe COVID-19 outcomes [25,34–41].…”

Section: Discussionsupporting

confidence: 76%

COVID-19 in people with HIV in the Netherlands, the ATHENA cohort study

Wit

Reiss

Rijnders

et al. 2023

Aids

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van der Valk a,b , on behalf of the ATHENA cohort study group Objectives: We investigated occurrence of and risk factors for severe COVID-19 outcomes in people with HIV (PWH) in the Netherlands.Design: An ongoing prospective nationwide HIV cohort study.Methods: COVID-19 diagnoses and outcomes with other relevant medical information were prospectively collected from electronic medical records in all HIV treatment centers in the Netherlands, from the start of the COVID-19 epidemic until December 31, 2021. Risk factors for COVID-19 related hospitalization and death were investigated using multivariable logistic regression, including demographics, HIV-related factors, and comorbidities. Results:The cohort comprises 21 289 adult PWH, median age 51.2 years, 82% male, 70% were of Western origin, 12.0% were of sub-Saharan African and 12.6% Latin American/Caribbean origin, 96.8% had HIV-RNA less than 200 copies/ml, median CD4 þ cell count 690 (IQR 510-908) cells/ml. Primary SARS-CoV-2 infections were registered in 2301 individuals, of whom 157 (6.8%) required hospitalization and 27 (1.2%) ICU admission. Mortality rates were 13 and 0.4% among hospitalized and nonhospitalized individuals, respectively. Independent risk factors for severe outcomes (COVID-19-related hospitalization and death) were higher age, having multiple comorbidities, a CD4 þ cell count less than 200 cells/ml, uncontrolled HIV replication, and prior AIDS diagnosis. Migrants from sub-Saharan Africa, Latin America, and the Caribbean were at an increased risk of severe outcomes independently of other risk factors. Conclusion:In our national cohort of PWH, risk of severe COVID-19 outcomes was increased in individuals with uncontrolled HIV replication, low CD4 þ cell count, and prior AIDS diagnosis, independently of general risk factors such as higher age, comorbidity burden and migrants originating from non-Western countries.

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Section: Discussionsupporting

confidence: 76%

COVID-19 in people with HIV in the Netherlands, the ATHENA cohort study

Wit

Reiss

Rijnders

et al. 2023

Aids

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“…Previous studies showed that TDF may alleviate symptoms of SARS‐CoV‐2 infection, while the efficacy of ETV is inconclusive 19,20,30 . To further investigate this issue, the CHB antiviral (+) population was divided into ETV and TDF subgroups.…”

Section: Resultsmentioning

confidence: 99%

Alleviated symptoms of SARS‐CoV‐2 Omicron variant infection in chronic hepatitis B patients with immune control

Liu,

Zhang,

Kong

et al. 2023

Journal of Medical Virology

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The impact of hepatitis B virus (HBV) infection on the progression of coronavirus disease 2019 (COVID‐19) disease remains controversial. We aimed to investigate whether pre‐existing chronic HBV (CHB) infection and therapy with anti‐HBV nucleos(t)ide analogs (NAs) influence the clinical presentation of severe acute respiratory syndrome coronavirus 2 (SARS‐CoV‐2) Omicron variant infection. In this study, clinical information was collected via a questionnaire from patients with COVID‐19, and their clinical symptoms were quantitatively assessed for comparative analyses. Additionally, hepatitis B‐related laboratory data were collected for CHB patients. Propensity score matching (PSM) was used to minimize confounding biases. A total of 785 patients with COVID‐19 were included in the cohort, of which 387 were identified as being infected with CHB infection and they were categorized as being in the immune control or clearance phase. After PSM, the CHB group (n = 222) had a shorter duration of fever and disease course, milder clinical symptoms, and lower incidence of pneumonia than the non‐CHB group (n = 222) after Omicron variant infection (p < 0.05). After the adjustment of confounding factors, CHB patients showed a lower risk of prolonged fever, severe clinical symptoms, and pneumonia (p < 0.05). However, there were no statistically significant differences in the clinical symptoms and incidence of pneumonia between CHB patients who received and did not receive NAs, or CHB patients who received tenofovir disoproxil fumarate and entecavir (p > 0.05). In conclusion, our findings suggest that the crosstalk of anti‐HBV immunity may contribute to the alleviated symptoms of SARS‐CoV‐2 Omicron variants infection in the CHB patients, independent of anti‐HBV NA therapy.

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“…In South Africa, a study found a nearly 60% lower risk of COVID-19 mortality with TDF/FTC vs. ABC or zidovudine after adjusting for kidney disease, viral suppression, and ART duration [ 10 ]. Similarly, a study among individuals with hepatitis B in Spain found that those on TDF had a lower risk of severe COVID-19 than those on entecavir [ 11 ]. In a recent publication, Li et al compared the adjusted risks of documented SARS-CoV-2 infection, COVID-19-related hospitalization, and intensive care unit admission by baseline ART regimen in a cohort of men living with HIV.…”

Section: Discussionmentioning

confidence: 99%

“…Different cohorts reported that people treated with TDF for HIV were less likely to develop SARS-CoV-2 infection and/or severe COVID-19 [ 8 , 9 , 10 ]. Moreover, regarding patients with hepatitis B and COVID-19, better outcomes were described in those on therapy with TDF vs. entecavir [ 11 ].…”

Section: Introductionmentioning

confidence: 99%

Tenofovir-Containing Antiretroviral Therapy and Clinical Outcomes of SARS-CoV-2 Infection in People Living with HIV

Rombini,

Cecchini,

Diana Menendez

et al. 2023

Viruses

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Tenofovir has been hypothesized to be effective against COVID-19 and is available as two prodrugs, tenofovir disoproxil fumarate (TDF) and tenofovir alafenamide (TAF), both part of antiretroviral therapy (ART) regimens. People living with human immunodeficiency virus (PLWH) might be at higher risk for COVID-19 progression; however, information about the impact of tenofovir on COVID-19 clinical outcomes remains controversial. The COVIDARE is a prospective observational multicentric study in Argentina. PLWH with COVID-19 were enrolled from September 2020 to mid-June 2022. Patients were stratified according to baseline ART into those with tenofovir (TDF or TAF) and those without. Univariate and multivariate analyses were performed to evaluate the impact of tenofovir vs. non-tenofovir-containing regimens on major clinical outcomes. Of the 1155 subjects evaluated, 927 (80%) received tenofovir-based ART (79% TDF, 21% TAF) whilst the remaining population was under non-tenofovir regimens. The non-tenofovir group had older age and a higher prevalence of heart and kidney disease. Regarding the prevalence of symptomatic COVID-19, tomographic findings, hospitalization, and mortality, no differences were observed. The oxygen therapy requirement was higher in the non-tenofovir group. In the multivariate analyses, a first model with adjustment for viral load, CD4 T-cell count, and overall comorbidities showed that oxygen requirement was associated with non-tenofovir ART. In a second model with adjustment by chronic kidney disease, tenofovir exposure was not statistically significant.

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Tenofovir Disoproxil Fumarate Reduces the Severity of COVID-19 in Patients with Chronic Hepatitis B

Cited by 9 publications

References 21 publications

COVID-19 in people with HIV in the Netherlands, the ATHENA cohort study

COVID-19 in people with HIV in the Netherlands, the ATHENA cohort study

Alleviated symptoms of SARS‐CoV‐2 Omicron variant infection in chronic hepatitis B patients with immune control

Tenofovir-Containing Antiretroviral Therapy and Clinical Outcomes of SARS-CoV-2 Infection in People Living with HIV

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