ArticleJournal of viral hepatitis2021
Low risk of hepatitis B reactivation in patients with severe COVID-19 who receive immunosuppressive therapy.
Article in Journal of viral hepatitis, 2021. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 46 papers, 3 of them syntheses that pooled it.
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Who cites it
46 citing papers in PubMed, 3 syntheses or guidelines pooled it, 78 citations in OpenAlex.
- Pooled it
- Correlation between COVID-19 and hepatitis B: A systematic review.World journal of gastroenterology · 2022Pooled it
- Immunomodulation as Treatment for Severe Coronavirus Disease 2019: A Systematic Review of Current Modalities and Future Directions.Clinical infectious diseases : an official publication of the Infectious Diseases Society of America · 2021Pooled it
- Risk of hepatitis B reactivation in COVID-19 patients receiving corticosteroid therapy: A retrospective cohort study.Medicine · 2026Article
- The risk of hepatitis B virus reactivation in COVID-19 patients treated with corticosteroids: a retrospective observational cohort study.BMC infectious diseases · 2026Observational
- COVID-19 and Liver Injury, Beyond the First Pandemic Waves: Clinical and Immune-Virological Features.Journal of viral hepatitis · 2025Article
- Surveillance Following Hepatitis B Surface Antigen Loss: An Issue Requiring Attention.Pathogens (Basel, Switzerland) · 2024Review
- Risk of Hepatitis B Virus Reactivation in COVID-19 Patients Receiving Immunosuppressive Treatment: A Prospective Study.Journal of clinical medicine · 2024Article
- Hepatitis B Reactivation and Liver Failure Because of COVID-19 Infection.ACG case reports journal · 2024Article
- Hepatitis B Virus Reactivation with Immunosuppression: A Hidden Threat?Journal of clinical medicine · 2024Review
- Insight into COVID-19 associated liver injury: Mechanisms, evaluation, and clinical implications.Hepatology forum · 2024Review
- Is Pulmonary Involvement a Distinct Phenotype of Post-COVID-19?Biomedicines · 2023Article
- Risk of hepatitis B reactivation following baricitinib or tocilizumab for treatment of COVID-19.European journal of clinical microbiology & infectious diseases : official publication of the European Society of Clinical Microbiology · 2023Article
- Tenofovir Disoproxil Fumarate Reduces the Severity of COVID-19 in Patients with Chronic Hepatitis B.Digestive diseases and sciences · 2023Article
- COVID-19: Has the Liver Been Spared?International journal of molecular sciences · 2023Review
- COVID-19 and the Liver: A Complex and Evolving Picture.Hepatic medicine : evidence and research · 2023Article
- Liver injury induced by COVID 19 treatment - what do we know?World journal of gastroenterology · 2022Review
- COVID-19-associated liver injury: Clinical characteristics, pathophysiological mechanisms and treatment management.Biomedicine & pharmacotherapy = Biomedecine & pharmacotherapie · 2022Review
- Hepatitis B virus infection reactivation in patients under immunosuppressive therapies: Pathogenesis, screening, prevention and treatment.World journal of virology · 2022Review
- Impact of Liver Functions by Repurposed Drugs for COVID-19 Treatment.Journal of clinical and translational hepatology · 2022Review
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Authors and funding
9 authors at 3 institutions in 1 country.
Funding
Abstract
A significant proportion of patients infected with SARS-CoV-2 develop severe respiratory symptoms due to an excessive immune response. Treatment of this condition may include immunosuppressive therapies, such as IL-6 receptor antagonists and corticosteroids, which pose a risk for patients with active or past hepatitis B virus (HBV) infection. In this prospective cohort study, we analysed the risk of HBV reactivation in patients with severe COVID-19 and resolved HBV infection undergoing immunosuppressive therapy. From 15th March to 30th April 2020, 600 patients with severe COVID-19 were admitted to our hospital and treated with immune modulators. Data regarding HBV infection were available in 484, of whom 69 (14%) were HBsAg negative/anti-HBc positive. For these patients, HBV reactivation prophylaxis with entecavir was strongly recommended. Complete follow-up was available in 61 patients: 72% were male, median age was 67 years, and anti-HBs was >10 IU/mL in 72%. The immunosuppressive drug most used was tocilizumab (72%). Despite HBV prophylaxis recommendation, 38 (62%) patients received entecavir and 23 (38%) did not. Baseline features of both groups were similar. At follow-up, we found no cases of HBsAg seroreversion and only 2 (3%) patients (no prophylaxis group) had detectable serum HBV-DNA (<15 IU/mL). Both were anti-HBs negative and had normal aminotransferase levels. Our data show that the risk of HBV reactivation in patients with severe COVID-19 and resolved HBV infection undergoing immunosuppressive treatment is low. However, if a systematic follow-up after hospital discharge is unfeasible in patients without anti-HBs, a short course of antiviral prophylaxis may be a safe option.
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